外周血甲胎蛋白mRNA对肝癌诊断价值的探讨  

Diagnostic Value of the alpha-fetoprotein mRNA in Peripheral Blood in Patients with Hepatocellular Carcinoma

作　　者：朱云松[1] 杨大明[2] 姚登福[2] 李玉明[1] 钱俊波[1] 樊锦河[1] 葛振明[1] 

机构地区：[1]江苏省南通市第一人民医院消化科,226001 [2]南通大学附属医院消化科

出　　处：《临床内科杂志》2008年第9期621-623,共3页Journal of Clinical Internal Medicine

摘　　要：目的探讨外周血甲胎蛋白(AFP)基因在原发性肝癌(HCC)早期诊断和鉴别诊断中的临床价值。方法从肝病患者外周血中制备RNA,以巢式聚合酶链反应(RT-PCR)扩增AFP基因。测定20份肝癌、癌周和远癌组织中总RNA浓度。结果远癌和癌周组织RNA浓度明显高于癌灶组织(P<0.05),癌组织中AFP基因检出率均为100%;肝癌患者外周血中AFP基因的检出率为53.7%,明显高于肝硬化、慢性肝炎、急性肝炎和肝外肿瘤组患者(P<0.01);在Ⅰ、Ⅱ和Ⅲ期肝癌中,AFP基因阳性率分别为33.3%、26.3%和71.8%;肝内有无转移的肝癌组间存在明显差异(P<0.05),尤其在伴有肝外远处转移的肝癌中,AFP基因全数阳性(100%);在AFP<200 ng/ml肝癌中,AFP基因阳性率为50.0%;与肝癌大小间未见统计学差异(P>0.05)。结论分析外周血中AFP基因有助于肝癌的诊断、肝癌远处转移判别及肝癌术后复发的监测。Objective To explore clinical value of the alpha-fetoprotein gene in early diagnosis and differential diagnosis of hepatoceUular carcinoma （HCC）. Methods The AFP-mRNA synthesized to cDNA through random primers and reverse-transcriptase were amplified by nested reverse transcription polymerase chain reaction （RT-PCR）. Results Of the 20 HCC patients,total RNA concentrations in paracancerous and distal cancerous tissues were significantly higher than those in cancerous tissues （P 〈 0.05 ）. The positive rate of peripheral blood gene fragments from patients with HCC was 53.7% in AFP. It was significantly higher than that in liver cirrhosis （LC）, chronic hepatitis （CH）, acute hepatitis （AH） and extrahepatic tumor （ET）. The presence of AFP-mRNA was correlated with the stage of HCC and the presence of intrahepatic metastasis. The AFP-mRNA was found in all metastasis at extrahepatie organs （ 100% ）. The positive rate of AFP gene in HCC with level of serum AFP less than 200ng/ml was 50.0%. There was no correlationship with tumor size in both gene expressions. Conclusion The present date suggests that the AFPmRNA analysis in peripheral blood is useful for HCC diagnosis, differentiation of HCC extrahepatic metastasis and monitoring recurrence after HCC operation.

关 键 词：肝癌 AFP基因 RT-巢式PCR 

分 类 号：R735.7[医药卫生—肿瘤]