AFP、h-TERT及VEGF基因在肝细胞癌患者外周血中的诊断价值

Diagnostic value of AFP, h-TERT and VEGF mRNAs in peripheral blood of patients with hepatocellular carcinoma

目的:探讨肝细胞癌(HCC)患者外周血中甲胎蛋白(AFP)、端粒酶逆转录酶(h-TERT)及血管内皮生长因子(VEGF) mRNA的表达及联合检测对诊断HCC的应用价值.方法:应用荧光定量PCR(FQ-PCR)对40例HCC、20例肝外良性疾病及10例正常体检人群的外周血AFP mRNA、h-TERT mRNA及VEGF mRNA的表达量进行检测.结果:3种指标在HCC患者中阳性率分别为77.5%、85%及72.5%,与对照组相比差异有统计学意义(P<0.01).且AFP mRNA、VEGF mRNA的阳性表达与HCC患者血清AFP水平无关(P>0.05),h-TERT mRNA与患者血清AFP水平存有相关性(P=0.01);3种指标与HCC患者的TNM分期高度相关(P<0.01).AFP mRNA在诊断HCC特异性较高,而AFP mRNA和h-TERT mRNA联合检测效果更好(敏感度92.%,特异度80%).结论:3种指标对诊断HCC均能起到良好的参考作用,联合检测AFP mRNA及h-TERT mRNA能增加诊断HCC的敏感度及特异度.

AIM： To evaluate the diagnostic significance of alpha-fetoprotein （AFP）, human telomerase reverse transcriptase （h-TERT） and vascular endothelial growth factor （VEGF） mRNAs in peripheral blood of patients with hepatocellular carcinoma （HCC）. METHODS： Fluorescence quantitative PCR （FQ-PCR） was used to detect the levels of AFP, h-TERT and VEGF mRNAs in peripheral blood samples from 40 patient with HCC, 20 patients with liver disease and 10 normal controls. RESULTS： The positive rates of all three parameters were significantly higher in HCC patients than in controls （all P 0.01）. The positive expression of AFP and VEGF was not correlated with serum AFP levels in HCC patients （P 0.05）, whereas h-TERT mRNA had a correlation with serum AFP levels （P = 0.01）. The positive rates of all three parameters were highly correlated with TNM stage in HCC patients （all P 0.01）. The specificity of AFP mRNA in the diagnosis of HCC was higher, and combined detection of AFP and h-TERT mRNAs had a higher accuracy. CONCLUSION： AFP, h-TERT and VEGF mRNAs in peripheral blood can be used as auxiliary parameters for the diagnosis of HCC, and combined detection of AFP and h-TERT mRNAs in peripheral blood can increase the sensitivity and specificity for diagnosing HCC.