化学免疫治疗对肝癌患者血液甲胎蛋白mRNA表达的影响  

Effect of Chemoimmunotherapy on Presence of Alpha Fetoprotein mRNAin Peripheral Blood of Patients with Primary Liver Cancer

作　　者：谢伟敏[1] 吴英德[1] 曹骥[2] 苏建家[2] 谢裕安[2] 覃柳亮[1] 胡晓桦[1] 

机构地区：[1]广西医科大学肿瘤医院内科,广西南宁530021 [2]广西肿瘤防治研究所病理研究室,广西南宁530021

出　　处：《癌症》2001年第8期876-879,共4页Chinese Journal of Cancer

基　　金：广西自然科学基金项目No9732029;广西自然科学基金项目No9316083

摘　　要：目的:探讨肝动脉化疗栓塞(transcatheterarterialchemoembolizationTACE)联合静脉滴注化学免疫治疗(chemoimmunotherapyCI)对原发性肝癌患者外周血甲胎蛋白(AFP)mRNA表达的影响及其临床意义。方法:应用巢式逆转录聚合酶链反应(nestedRTPCR)检测36例肝癌患者血液AFPmRNA表达在TACE+CI前后的变化,并与单纯接受TACE的35例患者比较。结果:在治疗后1周和4周,TACE组血AFPmRNA阳性率分别为54.3%和57.1%,与治疗前的51.4%(18/35)比较,差异无显著性(P均>0.05);而TACE+CI组血AFPmRNA阳性率各为22.2%和33.3%,分别显著低于治疗前(58.3%,21/36)和TACE组(P<0.01和P<0.05)。经过6～12个月随访,TACE+CI组平均缓解期为5.8±2.8月,有6例出现门脉癌栓或肝外转移(16.7%),而TACE组为3.7±2.6月和13例(37.1%),差异均有显著性(P<0.001和P<0.05)。结论:应用RTPCR技术检测原发性肝癌患者外周血AFPmRNA的动态变化对判断TACE等方法治疗肝癌的疗效有重要参考价值。联合静脉化学免疫治疗能显著降低肝癌患者外周血AFPmRNA的阳性率,可能对防止肝癌细胞的血行播散有积极意义。Objectives:To investigate the effect of chemoimmunotherapy(CI) on presence of alpha fetoprotein mRNA in peripheral blood of patients with primary liver cancer(PLC). Methods:AFP mRNA was amplified by nested RT PCR before and after transcatheter arterial chemoembolization(TACE)combined with chemoimmunotherapy (TACE+CI) or TACE alone. Results: Before treatment, positive rate of AFP mRNA was 58.3% and 51.4% in TACE+CI group (36 cases)and TACE group (35 cases), respectively (P >0.05). One week and four weeks after treatment, positive rate of AFP mRNA in TACE+CI group was 22.2% and 33.3%, respectively, which were significantly as comparing to that of pretreatment (P< 0.01 and P< 0.05, respectively). While, the presence of AFP mRNA had not significantly decreased in TACE group. Followed up from 6 to 12 months,the probability of developing in or ex trahepatic metastasis was significantly higher, and mean remission duration was significantly shorter in TACE group compared with TACE+CI group. Conclusions: AFP mRNA in peripheral blood in PLC patients may be a specific marker of curative effect of PLC. TACE combined with chemoimmunotherapy seems to be effective in preventing the hematogenous dissemination of the tumor cells.

关 键 词：肝肿瘤 聚合酶链反应 甲胎蛋白 mRNA 化学治疗 免疫治疗 

分 类 号：R735.7[医药卫生—肿瘤] R730.5[医药卫生—临床医学]