肝癌特异性AFP亚组分联合AFP-mRNA对肝癌诊断与鉴别价值  

Clinical values of combined hepatoma-specific α-fetoprotein (AFP) fraction and AFP-mRNA determination in diagnosis and differentiation of hepatocellular carcinoma

作　　者：吴玮[1] 姚登福[1] 袁咏梅[1] 樊冀伟[1] 陆秀凤[1] 李小华[1] 邱历伟[1] 吴信华[1] 

机构地区：[1]南通大学附属医院,南通226001

出　　处：《胃肠病学和肝病学杂志》2006年第3期268-270,共3页Chinese Journal of Gastroenterology and Hepatology

基　　金：南通市社会发展科技计划(s30033)

摘　　要：目的探讨甲胎蛋白(AFP)基因及肝癌特异性AFP亚组份(AFP-L3)在肝癌早期诊断和鉴别诊断中的价值。方法从肝病患者外周血中制备总RNA,以逆转录聚合酶链反应(RT-PCR)扩增AFP基因。用小扁豆凝集素亲和层析法分离血清中AFP-L3,放射免疫法测定AFP及AFP-L3。结果在肝癌和肝硬化病人中AFP-L3阳性率分别为91.7%(110/120)和18%(9/50),AFP-mRNA阳性率分别为56.7%(68/120)和16%(8/50),两者总阳性率分别为95%(114/120)和26%(13/50)。正常对照组AFP-L3及AFP-mR-NA均为阴性。肝癌病人AFP-L3%及AFP-mRNA阳性率明显高于肝硬化及正常对照组(P<0.01)。AFP-L3及AFP-mRNA与肿瘤大小、数目等无关(P>0.05),而与肿瘤分化程度、是否转移及有无复发等明显相关(P<0.05)。结论外周血AFP-L3及AFP-mRNA检测特异性强、敏感性高,有助于肝癌诊断与鉴别诊断、肝外转移或术后复发监测。Objective To explore the diagnostic values of hepatoma-specific alpha- fetoprotein fraction （AFP-L3） and circulating AFP-mRNA in patients with hepatocellular carcinoma （ HCC）. Methods Total RNAs were extracted from circulating blood, synthesized to cDNA through random primers and reverse transcriptase, the gene fragments of AFP were amplified by a nested-polymerase chain reaction （nested-PCR） assay. AFP-L3 was separated by lectin-affinity chromatography and both of AFP and AFP-L3 were detected by radio- immunoassay （RIA）. Results Of HCC and cirrhosis group, the incidences of AFP-L3 were 91.7% and 18% , and AFP-mRNA were 56.7% and 16%, respectively, and neither was found in the control group. The incidence of AFP-L3 or AFP-mRNA in HCC group was significantly higher （ P 〈 0.01 ） than that in liver cirrhosis group or control group. No significant relationship was found between AFP-L3 % or AFP-mRNA and tumor size or numbers, except for HCC differentiation, metastasis and relapse （ P 〈 0. 05 ）. Conclusion The analysis of AFP-L3 or AFP-mRNA fragment has better sensitivity, specificity, and both are useful markers to diagnose HCC or monitor metastasis and relapse.

关 键 词：肝癌 肝癌特异性AFP AFP-MRNA 亲和层析 RT-PCR 

分 类 号：R735.5[医药卫生—肿瘤]