原发性肝癌者外周血AFP mRNA的表达及其动态和意义

目的探讨AFP mRNA在原发性肝癌患者外周血的表达及其动态变化和临床意义.方法用巢式逆转录聚合酶链反应检测93例肝癌患者外周血AFP mRNA,并观察其中36例患者血AFP mRNA表达在治疗前后的动态变化.结果血AFP mRNA阳性率为52.7%(49/93),阳性率与肝癌临床分期、门静脉癌栓、肝外转移、癌灶大小、HBV感染和肝硬化程度密切相关,并和癌组织中AFP mRNA的表达水平密切相关(P＜0.05).随访结果显示,外周血AFP mRNA呈阳性的病例发生肝内外转移率显著高于阴性病例,癌灶缓解期明显短于阴性病例(P均＜0.05).联合全身化疗和免疫治疗可显著降低肝癌患者外周血AFP mRNA的阳性率.结论外周血AFP mRNA阳性表达是预示肝癌发生肝内外转移的重要标志.联合全身化学免疫治疗可显著降低血AFP mRNA阳性率,对预防肝癌细胞的血行播散、降低肝内外转移率和提高患者预后可能有积极作用.

Significance of Expression and Alteration of AFP mRNA in Peripheral Blood of Patients with Primary Liver Cancer

Objective:To evaluate the significance of alpha-fetoprotein(AFP)mRNA in peripheral blood of primary liver cancer(PLC)patients.Methods:Liver-specific AFP was am-plfied by nested RT-PCR.Results:The presence of AFP mRNA in patients with PLC(52.7%,49/93)seemed to be correlated with the clinical stage of PLC,portal vein thrombosis,extrahep-atic metastasis,size of tumor mass,HBV infection and Child's classification.The positive rate of AFP mRNA was significantly decreased after chemoimmunotherapy.The prognosis was worse in patients with positive AFP mRNA four weeks after treatment as compared with negative patients.Conclusion:AFP mRNA in peripheral blood may be a specific marker of hematogenous diffuse micrometastases in patients with PLC,and it was associated with the prognosis of patient.Chemoimmunotherapy seems to be effective in preventing hematogenous dissemination of tumor cells.