肝细胞癌患者血浆hTERT DNA的检测及其临床意义

Detection of plasma hTERT DNA level in hepatocelluar carcinoma patients and its clinical significance

目的检测肝细胞癌(HCC)患者血浆人端粒酶逆转录酶(human telomerase reverse transcriptase,hTERT)DNA水平并分析其临床意义。方法收集60例HCC患者术前血浆标本,21例HBV感染者及29例健康体检者血浆标本,提取血浆DNA,实时荧光定量PCR检测各组血浆hTERT DNA水平,分析3组间差异及与HCC患者临床特征之间的关系。结果 HCC患者血浆hTERT DNA水平明显高于HBV感染者和健康体检者,差异有统计学意义(P<0.01)。HCC患者血浆hTERT DNA水平与肿瘤大小呈正相关(r=0.382,P<0.01);与TNM分期和门静脉癌栓密切相关(P<0.05),与淋巴结转移、HBV感染及血清AFP水平不相关(P>0.05)。TNMⅠ～Ⅱ期及血清AFP≤20 ng/mL的HCC患者血浆hTERT DNA水平高于HBV感染者及体检健康者,差异有统计学意义(P<0.05)。结论血浆hTERT DNA检测对于HCC的早期筛查及病情监测有一定参考价值,值得进一步研究。

Objective To determine quantitatively the levels of human telomerase reverse transcriptase（hTERT） DNA in plasma of hepatocelluar carcinoma（HCC） patients,and analyze its clinical significance.Methods The samples of plasma were collected from 60 HCC patients before operation,and 21 HBV patients and 29 healthy individuals were enrolled as control.Plasma DNA was extracted and then quantified by real-time fluorescence quantitative PCR.The differences of plasma hTERT DNA level between the 2 groups and its relationship with clinical features were analyzed.Results Plasma hTERT DNA level of HCC patients was higher than that of HBV patients and healthy individuals with statistical significance（P0.01）.Plasma hTERT DNA level was positively correlated with tumor size（r=0.382,P=0.003）,and was closely relevant to TNM stage and cancer embolus in portal vein（P0.05）,but there was no association with lymph node metastases,HBV infection or serum AFP level（P0.05）.hTERT DNA levels in the plasma of HCC patients with TNM stage Ⅰand Ⅱ,or AFP less than 20 ng/mL was higher than that of HBV-infected and healthy groups with statistical significance（P0.05）.Conclusion Plasma hTERT DNA showed clinical value for early screening and monitoring of HCC and deserves for further study.