肝癌细胞血行播散对术后复发及远处转移的影响

目的 对照研究周围静脉血液中甲胎蛋白(AFP)mRNA阳性及阴性肝癌患者术后肿瘤复发和远处转移情况.方法 应用巢式RT-PCR检测术后24、48 h及1周、4周肝癌患者周围静脉血液中AFP mRNA水平,并术后随访1、2、3年.结果 12例术前及术后1周内血液AFP mRNA持续(+)的肝癌患者中,有7例在术后1年内产生了复发或转移性病灶(7/12,58.3%);所有患者在术后2年内均发生了肝癌复发和远处转移(12/12,2年复发率为100%).而在随访的19例血液AFPmRNA(-)肝癌患者中,有5例(5/19,26.3%)在术后1年内复发,4例在术后第2年复发(9/19,2年复发率为47.3%),1例术后第3年复发(10/19,3年复发率为52.6%),未出现肝外远处器官转移.术后1、2,3年复发率与对照组比较差异有统计学意义(P<0.01).结论 术后血液AFP mRNA持续(+)的肝癌患者较AFP mRNA阴性肝癌患者更容易产生复发或转移.

The influence of tumor cells spreading in blood to relapse and distant metastasis of hepatocellular carcinoma after surgery

Objective To study the relationship between peripheral blood hepatocellular carcinoma cells-associated AFP mRNA and tumor relapse and metastasis.Methods To detect several blood samples from the HCC patients by nested RT-PCR to find out AFP mRNA after24 h,72 h and one week and 4 weeks after surgery,and followed up the HCC patients for 1,2,3 years.Results There were 7 patients occurred relapse or distant metastasis in 12 patients with AFP mRNA positive(7/12,58.3%),there were 5 patients occurred relapse in 19 patients with AFP mRNA negative(5/19,26.3%)within 1 year,there was 4 patients occured relapse in second year(9/19,47.3%);5 patients occured relapse in third year(10/19,52.6%).Obvious connection between patients AFP mRNA positive and AFP mRNA negative Was observed(P<0.01).Conclusions HCC with AFP mRNA positive has more change to be recurrent compared with HCC patients with AFP mRNA negative.