肝硬化肝癌与白血病发病原理相关性研究

Studies on similarity of hepatocarcinogenesis in liver cirrhosis to leukomogenesis

目的参照白血病发病原理,探讨肝硬化肝癌发病机制。方法对8例肝硬化患者进行骨髓和外周血细胞遗传学研究,对12例肝硬化患者进行血清叶酸和维生素B_(12)水平测定,并对肝硬化肝癌中发现的V-erbB样基因和白血病V-erbB基因进行同源性分析。结果8例患者骨髓细胞染色体核型正常,但25%患者骨髓细胞SCD阴性(即细胞周期成倍延长),且有相同比例的患者骨髓出现超2n细胞。前者与难治性贫血(MDS-RA)相似,后者与ALL染色体异常类型相同。12例外周血细胞染色体检查中7例染色体脆性增加。血清叶酸水平显著下降,而维生素B_(12)则显著增加,与难治性贫血伴原始细胞增多(MDS-RAEB)相似,提示肝细胞的高度增生。肝癌所谓erbB样基因与V-erbB部分相同。结论肝癌和白血病有相似发病机制和相同致病基因,但激活机制不同。

Objective To study the mechanism of occurrence of primary liver cancer in reference to leukomogenesis.Methods Cytogenetic techniques,including R-banding karyotypic analysis and SCD exami- nation of BM cells;the expression of fragility of PB lymphocytes;measures of serum folic acid and B_(12)levels; homologue analysis of erbB-like gene,found in liver cancer by Dr.Zhang XK et al,and V-erbB.Results all(8/8) patients with liver cirrhosis have normal karyotype,but 25%(2/8)patients showed SCD negative of BM cells,as seen in MDS-RA.In same percentage of patients 10%～20% high diploidy BM cells were found,as seen in ALL.There are increased fragility in 7/12 patients,as seen in members of leukemia family.The significant de- crease of FA and increase of B_(12)were found in most of patients,as seen in patients with MDS-RAEB.This sug- gests that the proliferation of liver stem cells be at very high levels.So called erb-B like gene is a part of en- dogenous V-erbB.Conclusion Hepatocarcinogenesis in liver cirrhosis is similar to leukomogenesis in MDS.