TACE治疗肝癌前后外周血中AFP mRNA的变化及其意义研究  

Influence of TACE for primary hepatocellular carcinoma on tumor cells spreading in blood

作　　者：敖江帆[1] 肖永奇 倪恿文[3] 

机构地区：[1]郴州市第一人民医院肿瘤科,湖南郴州423000 [2]南昌铁路医院肿瘤科,江西南昌330006 [3]江西医学院附属第二医院肿瘤科,江西南昌330006

出　　处：《中华肿瘤防治杂志》2006年第15期1188-1190,共3页Chinese Journal of Cancer Prevention and Treatment

摘　　要：为探讨原发性肝细胞癌(primary hepatocellular carcinoma,PHC)患者肝动脉化疗栓塞术(transcatheter ar-terial chemoembolization,TACE)前、后周围静脉血液中AFP mRNA的变化及其意义。我们用巢式RT-PCR对21例TACE术的PHC患者进行其每次TACE前1周、后1周外周血中AFP mRNA的检测,以观测其变化。结果示21例PHC患者中首次TACE术前有13例(61.9%)血液中AFP mRNA检测阳性;8例(38.9%)首次TACE术前血液中AFP mRNA检测阴性;13例血液中AFP mRNA阳性患者中,有3例首次TACE后1周时转阴性(23.1%,P>0·05),4周时AFP mRNA转为阴性者共有5例(38.5%,P>0·05),第2次TACE术后1周时血液中AFP mRNA转为阴性者共有7例(53.8%,P>0·05),有6例未转阴(其中5例为肝内外转移者);8例首次TACE术前血液中AFP mRNA阴性者第1次TACE术后1、4周时仍为阴性,有2例在第2次TACE后1周时血液中AFP mRNA出现阳性(25%,P>0·05)。初步研究结果提示,TACE术治疗原发性肝癌对部分肝癌患者可以起到预防或阻止肝癌细胞血液转移的作用;多次TACE(≥2次)有引起肝癌细胞外周血转移的可能;介入期间辅以全身化疗及生物调节剂等综合治疗有必要性。The objective of this research was to study the influence of TACE for primary hepatocellular carcinoma（PHC） on tumor cells spreading in blood. By using nested RT-PCR, AFP mRNA content in 21 blood samples from the PHC patients were determined and the changes observed one week before each TACE and one week after each TACE. Of the 21 PHC patients, 13 patients（61.90//00） had positive AFP mRNA while 8 patients（38. 1%） had negative AFP mRNA before the first TACE. In 13 patients with blood AFP mRNA being positive before the first TACE, negative AFP mRNA was found in 3 cases one week after the first TACE, 5 cases four week after the first TACE, 7 cases one week after the second TACE, and six patients（in which there were 5 patients with intra-and extra-hepatic metastases） remained positive. Eight patients with blood AFP mRNA being negative before the first TACE didn＇t return to positive one week after the first TACE and four week after the first TACE, but 2 patients whose samples were originally negative for AFP mRNA later showed detectable AFP mRNA in the peripheral blood one week after the second TACE. In conclusion, the preliminary research results show that TACE has effect on preventing the hematogenous dissemination and metastasis in partial PHC patients. There is possibility of hematogenous metastasis of PHC after multiple TACE（≥2 times）. It is necessary to PHC patients that comprehensive treatment of systemic chemotherapy and immunotherapy etc is needed to PHC patients during TACE phase.

关 键 词：肝肿瘤/治疗 肝肿瘤/病理学 肝肿瘤/血液 化学栓塞 治疗性 甲胎蛋白类/遗传学 逆转录聚合酶链反应 

分 类 号：R735.7[医药卫生—肿瘤]