原发性肝癌组织VEGF与外周血AFP mRNA检测的临床意义

Clinical significance of VEGF protein expression in hepatoma tissue and the AFP mRNA expression in peripheral vein blood in hepatocellular carcinoma

目的 探讨肝癌组织中血管内皮生长因子 (VEGF)蛋白表达与外周血液中甲胎蛋白 (AFP)mRNA表达在原发性肝细胞癌转移中的意义。方法 用巢式逆转录PCR法检测 2 0例肝癌患者术前外周血液中的AFPmRNA ,对其手术切除标本采用免疫组化方法检测VEGF蛋白表达 ,结合临床病理资料进行配对分析。结果 (1) 2 0例原发性肝细胞癌中 10例VEGF为阳性表达 ,其表达情况与临床病理参数无明显相关 ;(2 ) 2 0例肝癌中 13例AFP≥ 2 0 0 μg/L ,15例外周血液中AFPmRNA阳性 ;(3 )VEGF阳性的 10例病例中有 9例在外周血中可检测到AFPmRNA。结论 (1)肝癌组织VEGF和外周血中AFPmRNA检测都可作为判断原发性肝癌有无血行转移倾向的指标 ,前者较为简单 ,而后者较为客观准确。 (2 )对肝癌高危人群的普查和肝癌术后随访 ,应用外周血中AFPmRNA的检测方法较血清AFP水平更加敏感。

Objective To study the significance of expression of VEGF in the hepatocellular carcinoma tissue(HCT) and the expression of AFPmRNA in the peripheral vein blood in hepatocellular carcinoma patients(HCC) with metastasis. Methods AFPmRNA was detected in peripheral blood before operation and the expression of VEGF in HCC tissue was analyzed by immunohistochemistry after operation in 20 patients. The relations between the expression of VEGF protein and AFPmRNA with clinicpathological parameters were analyzed statistically. Results (1)Among the 20 patients with HCC, 10 were positive expression of VEGF protein, which had no relation with the clinicopathological parameters. (2)Of the 20 patients, positive expression of AFPmRNA were detected in the peripheral blood in 15 patients, and AFP≥200μg/L were found in 13 patients.(3) AFPmRNA in the peripheral blood vein was detected in 9 of 10 patients with VEGF positive expression. Conclusions (1)Either VEGF protein expressed in HCC tissue or AFPmRNA detected in the peripheral blood could be as a guide line to judge the tendency of the metastasis of HCC,however former is simpler and the later is more sensitive . (2)The detection of AFPmRNA in the peripheral blood is more sensitive than the detection of serum AFP lever for surveillance of the high risk patients and postoperative follow up of the patients with HCC.