原发性肝癌患者外周血中肝细胞特异性白蛋白mRNA的检测及意义

The clinical significance of detection of albumin mRNA in peripheral venous blood from patients with hepatocellular carcinoma

目的：寻找一敏感的方法以发现循环中的肝癌细胞。方法：巢式RT－PCR检测外周血有核细胞成分中白蛋白（ALB）mRNA。结果：30例肝癌中门例检出ALBmRNA，阳性率56．6％，其中10例证实有转移的全部阳性。5例急性肝炎中的1例和9例慢性活动性肝炎中的1例可检出ALBmRNA。肝硬化、肝转移癌患者、良性肝肿瘤和健康对照组均为阴性。外用血细胞ALBmRNA的存在与肝癌的远处器官转移密切相关。结论：检测肝癌患者外周血ALBmRNA，可早期发现肝癌细胞的血行播散，对肝癌的诊断和治疗有辅助作用。

Purpose: We attempted to detect circulating hepatocellular caicinoma(HCC) cells by demonstrating albumin messenger RNA (mRNA) of a specifically hepatocyte-expressed gene in the nuclear cell component of peripheralblood. Method: Reverse transcription coupled with two-step polymerase chain reaction(Nested PT-PCR) was used to detect ALBmRNA expression in the peripheral blood obtained from patients with HCC and control groups. β2MmRNA was selected as an internal control. Results:By this highly sensitive method, detection of ALBmRNA expression was positive in 17 of 30 HCC patients (56.7%. 10 patients with clinically distant metastasis were all posititve (100%). In control, 1 fo 4acute hepatitis and 1 of 9 chronic hepatitis patients showed detectable ALB mRNA, but disappeared following the disease improved. ALBmRNA was not detected in samples from 13 cirrhosis, 8 benign liver tumour, 6 other tumours metastatic toliver and 13 normal healthy volunteers. The presence of ALBmRNA in blood seemed to be correlated with the the presence of distant metastasis of HCC. Conclusion:Nested RT-PCR is a very sensitive method for detecting the ALBmRNA in peripheral blood. Its presence may be an indicator of circulating HCC cells, which might predict hematogenous spreading metastasis of tumour cells in HCC patients. Important information for guiding management of HCC can be acquired with this technique.