原发性肝细胞癌RNA,DNA含量测定及临床意义

Analysis of Cellular RNA and DNA Contents of Primary Heptocellular Carcinoma and Its Clinical Significance

目的 探讨原发性肝细胞癌RNA ,DNA定量测定的临床意义。方法 应用流式细胞分析技术 ,对 6 4例原发性肝细胞癌 (PHC)RNA ,DNA含量进行定量分析 ,并对病人进行 1～ 5 5年的随访。结果 RNA指标和DNA指标对PHC的临床病理诊断符合率分别为 93 7%和 75 0 % ,RNA指标更敏感 ,双指标联合应用与临床病理诊断符合率为 96 8% ;DNA倍体与年龄、HCV感染密切相关 (P <0 .0 5 ) ,与性别、AFP水平、HBsAg及瘤体大小无关 ;DI随组织学分级的增高而增加 (P <0 .0 5 ) ,RNA和DNA含量与预后密切相关 (P <0 .0 1～ 0 .0 5 )。结论 RNA ,DNA含量可作为PHC诊断及判断预后的理想指标 ,RNA及DNA双指标同时应用优于其中任一单项指标。

Objective To analyze the cellular RNA and DNA contents of primary heptocellular carcinoma and To explore its clinical significance. Method The cellular RNA and DNA contents of 64 patients with primary heptocellular carcinoma (PHC) were analysed by flow cytometry. All patients had been followed-up for one to five and a half years. Result The results showed that the accuracy rates of diagnosis of RNA index (RI) and DNA index (DI) were 93.7% and 75.0% in PHC respectively. Statistically the RI was significantly more sensitive than DI (P<0.05). Analysis with both RI and DI, the accuracy rate was 96.8%. The incidence of aneuploid PHC was higher in patients under 50 years of age and in relation with infection of HCV. However, there was no significant correlation in between DNA ploidy and patient's sex, serum AFP level, HBsAg or tumor size (5 cm as threshold). The DI was correlated with the histologic grading (grade Ⅰ DI=1.25, grade Ⅱ DI=1.40, grade Ⅲ DI=1.51, grade Ⅳ DI=1.68). Conclusion It's considered that flow cytometry DI may be an objective and precise quantitative marker in judging the degree, grade and differentiation of PHC. The RI and DI may be important for indicating the bilogical nature of PHC.