肝细胞癌患者血浆循环DNA的定量分析及临床意义  

Quantitative analysis of circulating DNA level in plasma from patients with hepatocellular carcinoma and its clinical significance

作　　者：冉贵萍[1,2] 黄海[1] 杨国珍[1] 郭鹏 袁勇 

机构地区：[1]贵阳医学院检验系,贵州贵阳550004 [2]上海奉贤区奉城医院,上海201411

出　　处：《中国实验诊断学》2015年第6期918-921,共4页Chinese Journal of Laboratory Diagnosis

基　　金：国家级教学团队(教高函[2009]18号)

摘　　要：目的定量检测肝细胞癌(HCC)患者血浆循环DNA(cf-DNA)含量,探讨其在原发性肝癌早期诊断及病情监测中的临床应用价值。方法收集40例肝细胞癌、30例代偿期肝硬化、20例活动性肝炎和25例正常健康对照血浆,提取血浆循环DNA,采用real-time实时荧光定量PCR方法检测β-actin基因的表达,确定血浆循环DNA的水平。结果 HCC组、肝硬化组、肝炎组和健康对照组中位血浆循环DNA浓度分别为17.090ng/ml、8.182ng/ml、7.447ng/ml和9.014ng/ml,HCC组和健康对照组循环DNA水平比较有显著性差异(P<0.05);肝硬化组、肝炎组和健康对照组比较无显著性差异(P>0.05),ROC曲线分析表明血浆循环DNA水平能够区分肝癌和健康人(AUC=0.8450),以循环DNA水平11.92ng/ml作为诊断HCC的临界值,其诊断的特异度是84.0%,敏感度是72.5%。血浆cf-DNA浓度与AFP联合检测可以将HCC诊断率提高至77.5%。结论 real time PCR技术可精确定量血浆循环DNA浓度,检测血浆中循环DNA含量可作为诊断和监测原发性肝癌指标的有效补充。Objective To quantify the circulating DNA level in plasma from patients with hepatocellular carcinoma（HCC）,and to explore its significance for early diagnosis in HCC patients.Methods Blood samples were collected from 40 HCC patients,30 patients with liver cirrhosis,20 patients with chronic active hepatitis and 25 healthy controls.Circulating DNA in plasma was extracted and quantified by detecting theβ-actin gene through real-time quantitative PCR method.Results The median values of plasma circulating DNA concentration among the HCC group,cirrhosis group,hepatitis group and healthy control group were 17.090ng/ml,8.182ng/ml,7.447ng/ml and 9.014ng/ml respectively.There is significant difference between the HCC group and healthy control（P〈0.05）and no significant difference between the cirrhosis group and healthy control（P〉0.05）,no significant difference between the hepatitis group and healthy control（P〉0.05）.Receiver operating characteristic（ROC）analysis demonstrated that the circulating DNA level could be used to distinguish HCC from healthy control（AUC=0.8450）with sensitivity of 72.5% and specificity of 84.0% at the cut-off value of 11.92ng/ml.The combined analysis of using both plasma circulating DNA level and AFP revealed an elevated detection rate of 77.5%.Conclusion The detection of plasma circulating DNA level can be an effective supplement index for the diagnosis of HCC.

关 键 词：肝细胞癌 循环DNA 实时荧光定量PCR 

分 类 号：R735.7[医药卫生—肿瘤]