肝细胞癌在血中微小转移的检测

Detection of the micro-metastasis in peripheral blood of patients with hepatocellular carcinoma

目的 肝细胞癌患者术后复发常是术前不能检出微转移灶或术中瘤细胞释放入血之故。建立早期检出肝细胞癌 (HCC)血中微小转移的方法并评价其临床意义。方法 采用巢式RT PCR检测肝细胞特异白蛋白 (ALB)mRNA和甲胎蛋白 (AFP)mRNA在HCC患者外周血有核细胞成分及组织标本中的表达情况。并以肝癌细胞系HepG2 、SMMC772 1,乳腺癌细胞MCF 7作为阳性、阴性对照。结果 在肝组织 ,无论是癌、癌旁还是正常组织 ,ALBmRNA的表达均为阳性 (8/8) ;而AFPmRNA在癌组织7/8例表达 ,癌旁 5 /8例表达。外周血表达的情况为 :同一组标本ALBmRNA的阳性率为 75 .6 % (34 /4 5 ,P <0 .0 1) ,AFPmRNA的阳性率为 5 7.8% (2 6 /4 5 ,P <0 .0 1)。在有肝外转移和无肝外转移分组中 ,ALBmRNA和AFPmRNA的表达分别为 10 0 .0 % ,5 4.2 %和 90 .5 % ,2 9.2 %。结论 在HCC患者外周血有核细胞成分中检测ALBmRNA和AFPmRNA的表达 ,是预测转移、复发的简捷手段 ,若ALB与AFP二者联合使用 。

Objective The high relapse rate of primary hepatocellular carcinoma patients after operation is usually attributed to either failure to detect micro\|metastasis before operation or the release of tumor cells into blood during operation. The aim of this study was to set up the method of early detecting micro-metastasis in peripheral blood of patients with hepatocellular carcinoma(HCC) and to evaluate its clinical significance. Methods The expression of liver\|specific albumin(ALB) and alpha-fetoprotein(AFP) was measured by nested reverse transcription-polymerase chain reaction(RT\|PCR). Liver-cancer cell line HepG2 and SMMC7721 were used as positive control, and breast-cancer cell line MCF-7 was used as negative control. Results The expression of ALB mRNA was 100.0% (8/8) in the liver tumor, para-tumor, and normal liver tissues. The expression of AFP mRNA was 87.5%(7/8) in liver tumor tissue and 62.5%(5/8) in para-tumor tissue. In HCC patients, the positivity of ALB mRNA was positive in 75.6%(34/45) and that of AFP mRNA was 57.8%(26/45) in peripheral blood. The positivity of ALB mRNA and AFP mRNA in patients with and without extrahepatic metastasis was 100.0%, 54.2% and 90.5%, 29.2% respectively. Conclusions The measurement of ALB mRNA or AFP mRNA in peripheral blood with nested RT-PCR is a simple method to detect the metastasis and relapse of hepatocellular carcinoma. If ALB and AFP are used together, their application will be more widespread.