不同手术方式对肝癌患者外周血甲胎蛋白mRNA的影响  

A study on the influence of different methods on peripheral circulation micrometasis of tumor cells by detecting AFP mRNA

作　　者：何振兴 杨红春 李永 陈运龙 马海 魏正强[2] 

机构地区：[1]四川省南充市中心医院普外科,四川南充637000 [2]重庆医科大学附一院普外科,重庆400016

出　　处：《实用医院临床杂志》2011年第1期40-42,共3页Practical Journal of Clinical Medicine

摘　　要：目的通过对行腹腔镜肝癌切除术患者术前及术后外周血甲胎蛋白(AFP)mRNA的测定,探讨腹腔镜肝癌切除术对肿瘤外周血微转移的影响。方法采用实时定量的FQ-PCR方法,检测21例行腹腔镜肝癌切除术患者(腹腔镜组)术前及术后外周血AFP mRNA的表达;同时以33例开腹肝癌切除术(开腹组)及10例肝脏良性病变手术(良性对照组)作为对照,对比测定其术前术后外周血AFP mRNA的表达变化。结果术前腹腔镜组及开腹组外周血AFP mRNA表达阳性率分别为71.43%(15/21)、72.73%(24/33),明显高于良性对照组(良性对照组术前、术后均无阳性表达);术后外周血AFP mRNA表达阳性率腹腔镜组及开腹组分别为85.71%(18/21)、87.88%(29/33),与术前比较,差异均无统计学意义(χ2=1.273,P=0.259;χ2=2.395,P=0.122);术后腹腔镜组及开腹组之间比较,差异无统计学意义(χ2=0.053,P=0.817)。结论腹腔镜肝癌切除术相比传统开腹手术不增加肿瘤微转移的风险。Objective To study the influence on laparoscopic hepatectomy in peripheral circulation micrometastasis by detecting the alpha fetoprotein （AFP） mRNA expression in peripheral venous blood of patients with hepatocellular carcinoma （HCC） before and after operation. Methods Peripheral venous blood samples were collected before and after tumor resection in 21 patients with HCC by laparoscopic hepatectomy. Thirty-three patients with HCC underwent open hepatectomy and 10 patients with benign non：HCC liver neoplasms were regarded as controls. AFP mRNA expression in all blood samples were measured by FQ-PCR. Results The positivity rate of AFP mRNA of laparoscopic hepatectomy group before operation was 71.43 % （ 15/21 ）, and it was 85.71% （ 18/21 ） after operation. The positivity rate of AFP mRNA of open tumor resection group before operation was 72. 73% （24/33 ） , and it was 87. 88% （ 29/33 ） after operation. There was no AFP mRNA expression in the samples of benign non-HCC liver neoplasms before and after operation. The sensitivity1 specificity,accuracy rate of AFP mRNA expression in HCC peripheral venous blood were 72. 22%, 100% and 76. 56% respectively. Before and after operation, the AFP mRNA expression positivity rate of laparoscopic hepatectomy group and open tumor resection group was higher than that of the benign non-HCC liver neoplasms group. The AFP mRNA expression positivity rate after operation was higher than that before operation in both laparoscopic hepatectomy group and open tumor resection group, but the difference was not significant （X2 = 1. 273,P = 0. 259 ; X2 = 2. 395, P = 0. 122 ）. After operation, there was no significant difference in the AFP mRNA expression positivity rate between the laparoscopic hepatectomy group and the open tumor resection group. Conclusion Laparoseopic hepateetomy does not increase the risk of peripheral circulation micrometastasis comparing with open operation.

关 键 词：癌 肝细胞 腹腔镜 甲胎蛋白 MRNA 肿瘤转移 

分 类 号：R735.7[医药卫生—肿瘤] R730.56[医药卫生—临床医学]