肝癌病人外周血及骨髓AFP mRNA的检测及意义

α-fetoprotein mRNA detection in peripheral blood and bone marrow in patients with hepatocellular carcinoma and its sigificance

目的 通过检测AFPmRNA在肝细胞性肝癌 (hepatocellularcarcinoma ,HCC)病人外周血和骨髓中的表达 ,探讨AFPmRNA作为HCC微转移指标的可能性。方法 建立敏感的巢式逆转录聚合酶链反应体系 (Nested RT PCR) ,检测 71例HCC、36例肝硬化、9例肝血管瘤、11例肝转移瘤、30例正常对照外周血AFPmRNA和 19例HCC、15例血液病骨髓AFPmRNA。结果 71例HCC外周血中 38例AFPmRNA表达阳性 (5 3 5 %) ,肝硬化、肝血管瘤、肝转移瘤和正常对照均为阴性。HCC外周血AFPmRNA检出率与血清AFP值无明显相关 (P >0 0 5 ) ,而与肿瘤大小、门静脉癌栓、肝内转移、肝外转移等临床参数有明显相关 (P <0 0 5 )。 19例HCC骨髓中 9例AFPmRNA表达阳性 (4 7 4 %) ,15例血液病为阴性。骨髓AFPmRNA检出率与血清AFP值、肝内转移无明显相关 (P>0 0 5 ) ,与肿瘤大小、门静脉癌栓、肝外转移明显相关 (P <0 0 5 )。外周血和骨髓AFPmRNA的表达呈一致性 (P <0 0 5 )。结论 血循环AFPmRNA可作为HCC微转移的早期检测指标。HCC病人外周血和骨髓AFPmRNA的表达与复发转移显著相关 ,且HCC病人外周血和骨髓AFPmRNA的表达呈一致性 ,联合检测有助于提高结论的可靠性。

Objective To investigate the expression of α-fetoprotein (AFP) mRNA in peripheral blood and bone marrow of hepatocellular carcinoma (HCC) and probe into the possibility of AFP mRNA as a marker of micrometastasis in HCC. Methods A sensitive nested-RT-PCR system was set up to detect the AFP mRNA in peripheral blood of 71 HCC patients, 36 cirrhotic patients, 9 liver hemangioma patients and 11 metastatic liver carcinoma patients. Another 30 non-hepatobiliary system disease patients were employed to serve as the control. AFP mRNA in the bone marrow of 19 HCC patients was compared with that of 15 patients with hematologic diseases. Results Thirty-eight of the 71 HCC patients (53.5%) were positive for AFP mRNA in their peripheral blood while other patients were all negative. The presence of detectable AFP mRNA in peripheral blood was correlated to clinical characteristics such as tumor size, portal vein tumor thrombus (PVTT), intrahepatic metastasis and extrahepatic metastasis except for serum AFP level. Nine of the 19 HCC patients (47.4%) were positive for AFP mRNA in their bone marrow and no positive bands were found in 15 patients with hematologic diseases. The positive results in bone marrow were correlated with tumor size, PVTT, extrahepatic metastasis but not with serum AFP level and intrahepatic metastasis. The presence of AFP mRNA in peripheral blood was consistent with that in bone marrow. Conclusions Blood AFP mRNA can be a early detection marker for micrometastasis. The AFP mRNA test findings in peripheral blood and bone marrow are significantly correlated with recurrence and metastasis. The expression of AFP mRNA in peripheral blood was consistent with that in bone marrow. Therefore, the combined detection may enhance the reliability of the results.