原发性肝癌细针活检端粒酶活性检测的临床意义  

Clinical Significance of Detection of Telomerase Activity in Percutaneous Fine-needle Biopsied Tissues of Hepatocellular Carcinoma

作　　者：范瑞芳[1] 卫立辛[1] 王维锋[1] 尤天庚[1] 杨家和[1] 杨庆[1] 贾凤岐[1] 江小玲[1] 郭亚军[1] 吴孟超[1] 

机构地区：[1]第二军医大学东方肝胆外科医院肿瘤免疫和基因治疗中心,上海市200438

出　　处：《中国肿瘤临床》2004年第15期844-847,共4页Chinese Journal of Clinical Oncology

基　　金：国家重点基础研究发展规划项目(973项目)基金资助(编号:G2000057001)

摘　　要：目的:探讨原发性肝癌(HCC)经皮肝穿刺细针活检端粒酶活性检测的临床意义。方法:25例直径1.2～3cm的HCC进行了无水酒精注射治疗(PEIT)。PEIT治疗前及PEIT治疗后1周在B超引导下经皮肝穿刺细针活检,所得微量肝癌组织采用非放射性同位素银染端粒重复序列扩增法(TRAP)行端粒酶活性检测及病理学检查。3例正常肝脏组织及5例肝硬变组织作为对照研究。结果:PEIT治疗前,病理学检查诊断率为80%(20/25),端粒酶活性阳性率为84%(21/25);PEIT治疗后1周,病理学检查未发现肿瘤细胞,3例端粒酶活性阳性(12%),其中1例经手术治疗后临床治愈,2例未手术治疗者1年内复发。其余22例端粒酶转阴的患者1年内未复发。3例正常肝脏组织及5例肝硬变组织端粒酶活性检测均阴性。结论:经皮肝穿刺活检微量肝脏组织端粒酶活性检测可应用于小肝癌的辅助诊断,在原发性肝癌PEIT治疗的疗效评价及预后判断方面具有一定的应用价值。Objective: To evaluate the clinical significance of detection of telomerase activity in percutaneous fine-needle biopsied tissues of hepatocellular carcinoma (HCC). Methods: 25 patients with small HCC (1.2-3cm in diameter) were treated with percutaneous ethanol injection therapy (PEIT). Fine-needle biopsies by ultrasound guidance were performed in all HCC nodules before PEIT and one week after PEIT for detection of telomerase activity by non-radioisotopic silver staining telomeric repeat amplification protocol (TRAP) and histopathological diagnosis. Liver-biopsied samples from 3 normal liver tissues and 5 cirrhotic liver tissues were used as control groups. Results: The positive rates of histopathological diagnosis and telomerase activity detection in biopsied tissues before PEIT were 80% (20/25) and 84%(21/25), respectively. In re-biopsied tissues after PEIT, residual neoplastic cells were not demonstrated by histopathological examination in all cases, and telomerase activity were detected in 3 cases (12%). Among the 3 cases with persistent telomerase activity, one case had no recurrence after hepatectomy and the remaining 2 cases showed local recurrence within one year. 22 cases with negative telomerase activity after PEIT were not recurred during follow-up within one year. There was no telomerase activity in 3 normal liver tissues and 5 cirrhotic liver tissues. Conclusions: Detection of telomerase activity in percutaneous fine-needle biopsied tissues can be used as an alternative adjuvant diagnostic method for small HCC, and might be applied in evaluating the therapeutic efficacy of PEIT and judging the prognosis for HCC.

关 键 词：肝细胞癌 活组织检查 端粒酶 无水酒精 

分 类 号：R735.7[医药卫生—肿瘤]