sICAM-1和GPC-3 mRNA对肝癌诊断与转移监测的临床价值  

Clinical significance of circulating sICAM-1 and GPC-3 mRNA expression in the diagnosis and prognostic evaluation of hepatocellular carcinoma

作　　者：姚敏[1] 杨君伶[2] 蔚丹丹[2] 严晓娣[2] 陈洁[2] 姚登福[2] 

机构地区：[1]南通大学医学院免疫学教研室,江苏省南通市226001 [2]南通大学附属医院临床医学研究中心,江苏省南通市226001

出　　处：《世界华人消化杂志》2012年第21期1927-1932,共6页World Chinese Journal of Digestology

基　　金：南通市社会发展基金资助项目;No.S2010039;No.SH2011012;江苏省卫生科技基金资助项目;No.H2009025;江苏省高校优势学科建设(PADA)基金资助项目~~

摘　　要：目的:定量分析肝病患者血可溶性细胞间粘附分子-1(sICAM-1)浓度和外周血单核细胞磷脂酰肌醇蛋白多糖-3(GPC-3)mRNA,探讨对肝癌(HCC)诊断与预后的价值.方法:收集住院肝病患者外周血,分离单核细胞,制备总RNA,经逆转录合成GPC-3cDNA,以荧光定量PCR扩增;并以酶联免疫吸附法(ELISA)定量分析血ICAM-1水平.结果:肝病发展过程中血ICAM-1表达呈梯度增加,HCC患者血ICAM-1表达显著高于肝硬化(t=3.184,P=0.002)和慢性肝炎患者(t=3.962,P<0.001),与伴门脉癌栓(t=2.941,P=0.005)及肝外转移(t=3.282,P=0.002)明显相关,与患者年龄、性别、HBsAg阳性与否、AFP浓度及肿瘤大小间未见明显相关.GPC-3mRNA阳性仅见肝癌患者(70.9%);肝硬化、慢性肝炎患者及正常对照组中未检出(2=26.773,P<0.001).GPC-3mRNA阳性表达与HBsAg阳性(2=14.601,P<0.001)、肝癌TNM分期(2=17.732,P<0.001)、伴门脉癌栓及肝外转移(2=22.271,P<0.001)显著相关,与瘤体直径、数目、AFP浓度及分化程度未见明显相关;两者可互补诊断,提高诊断肝癌阳性率.结论:sICAM-1和GPC-3mRNA检测是肝癌诊断和转移监测的良好标志物,且对AFP阴性肝癌具有互补诊断价值.AIM：To quantitatively detect the levels of circulating soluble intercellular adhesion molecule-1（sICAM-1） and glypican-3（GPC-3） mRNA expression in peripheral blood mononuclear cells（PBMCs） in patients with liver diseases for exploring their significance in the diagnosis and prognostic evaluation for hepatocellular carci-noma（HCC）.METHODS：Total RNA was extracted from circulating PBMCs collected from patients with liver diseases.GPC-3 cDNA was synthetized by reverse transcription and amplified by fluorescent quantitative PCR.The levels of circulating ICAM-1 were quantitatively detected by enzyme-linked immunosorbent assay.RESULTS：The levels of sICAM-1 were increasing during the development of liver diseases,significantly higher in HCC patients than in those with liver cirrhosis（t = 3.184,P = 0.002） or chronic hepatitis（t = 3.962,P 〈 0.001）.sICAM-1 levels were significantly associated with periportal cancerous embolus（t = 2.941,P = 0.005） and extrahepatic metastasis（t = 3.282,P = 0.002）,but not with patients’ age,sex,AFP level,HBsAg positivity,or tumor size.The positive expression of GPC-3 mRNA in PBMCs was found only in HCC patients（70.9%,39 of 55）,and not in patients with liver cirrhosis,chronic hepatitis,metastatic liver cancer,non-liver tumors,or normal controls（2 = 26.773,P 〈 0.001）.The expression of GPC-3mRNA in PBMCs was associated with HBV infection（2 = 14.601,P 〈 0.001）,TNM stage（2 = 17.732,P 〈 0.001）,periportal cancerous embolus,and extrahepatic metastasis（2 = 22.271,P 〈 0.001）,and not with tumor size,tumor number,AFP level or differentiation degree.Combined detection of GPC-3 mRNA and serum AFP level could improve the detection rate of HCC.CONCLUSION：Detection of circulating sICAM-1 and GPC-3 mRNA in PBMCs could be used for the diagnosis and metastasis monitoring of HCC,especially in AFP-negative patients with HCC.

关 键 词：肝细胞癌 磷脂酰肌醇蛋白多糖-3信使核糖核酸 可溶性细胞间粘附分子-1 诊断 转移 

分 类 号：R735.7[医药卫生—肿瘤]