hTERT在原发性肝癌中的表达及其临床意义

Expression and clinical significance of hTERT in hepatocellular carcinoma

目的探讨端粒酶逆转录酶(hTERT)在原发性肝癌(HCC)中的表达,为肝癌早发现、治疗方案的选择、预后分析提供理论根据。方法 (1)采用免疫组化、RT-PCR法检测HCC及其癌旁组织和正常肝组织中hTERT基因表达水平。(2)比较hTERT检测和影像检查的诊断阳性率并对部分患者进行随访。结果 (1)hTERT在HCC和癌旁组织的阳性表达差异有显著性(P<0.01)。正常肝组织未见阳性表达。(2)hTERT检测诊断小肝癌阳性率高于影像学诊断;hTERT与影像学在癌旁组织的诊断阳性率差异有显著性(P<0.01)。(3)18例患者在随访期内有7例发生转移复发,均为hTERT阳性表达者。结论 (1)hTERT在肝癌组织中呈高表达水平;(2)hTERT在肝癌组织诊断中,小肝癌阳性率高于影像学诊断,癌旁组织诊断中,hTERT优于影像学诊断。(3)hTERT具有预示肝癌复发、转移的作用,可能成为辅助诊断和预后判断的指标之一。

Objective To investigate human telomerase reverse transcriptase （hTERT） expression in HCC tissues, provides the basic theory for HCC early detection, treatment choices, prognostic analysis. Methods （ 1 ） hTERT gene expression was detected by immunohistochemistry and RT- PCR methods in HCC and the tissues adjacent HCC and normal liver tissue; （2） to compare the positive diagnostics rate of image diagnosis and hTERT detection in HCC and follow up patients. Results （ 1 ） There was significant difference of hTERT expression between HCC and paracarcinomatous tissues （P 〈 0. 01 ）. and no hTERT expression in normal liver tis- sues. （2） The positive rate of diagnosis in small HCC is higher than what imaging is;and there was significant difference of the positive diagnostics rate between hTERT and imaging （P 〈 0.01 ）. （3） During the follow -up period, 7 cases of cancer metastasis or recur- rence were variable in 18 cases ,whom all had hTERT gene expression. Conclusions （ 1 ） hTERT in hepatocellular carcinoma tissues has a higher expression levels; （2） hTERT ,in diagnosis of HCC ：the positive rates of hTERT is higher than that of imaging diagnosis in small HCC;In the diagnosis of tissue adjacent to carcinoma, hTERT is superior to imaging diagnosis. （3） hTERT has heralded the recurrence and metastasis of HCC, which maybe become a valuable marker for diagnosis and prognosis of HCC.