肝癌患者围手术期外周血黑色素瘤抗原-1mRNA和甲胎蛋白mRNA检测与术后复发的关系

目的 探讨肝细胞癌患者围手术期外周血MAGE-1mRNA和甲胎蛋白(AFP)mRNA表达水平其与术后转移复发的关系。方法 通过巢式RT—PCR,在围手术期检测了45例肝细胞癌患者外周血MAGE-1mRNA和AFPmRNA,并进行平均11个月的随访。同时以22例肝炎后肝硬化、11例肝血管瘤、12例肝转移癌患者和20例健康志愿者外周血标本作为对照组进行了MAGE-1mRNA和AFP mRNA的对比检测。结果 MAGE-1mRNA在12例肝转移癌患者外周血中的检出率为33．3％(4／12);肝炎后肝硬化、肝血管瘤患者和健康志愿者中均未检出。AFP mRNA在肝炎后肝硬化患者外周血中的检出率为13．6％(3／22),在肝转移癌、肝血管瘤患者和健康志愿者中均未检出。45例肝细胞癌患者外周血中,MAGE-1mRNA／AFP mRNA的检出率分别是术前42．2％(19／45)／51．1％(23／45),术后7d20％(9／45)／24．4％(11／45),术后28d15．6％(7／45)／22．2％(10／45)。统计分析提示,术后28d肝细胞癌患者外周血检出MAGE-1 mRNA／AFPmRNA预示患者近期复发。并且双标志物联合检测较单标志物检测对预测复发具有更高的敏感性。结论采用巢式RT—PCR的方法联合检测肝细胞癌患者术后28d外周血中癌特异性的MAGE-1 mRNA和肝细胞特异性的AFP mRNA有助于预测肝细胞癌患者术后的转移复发。

Perioperative detection of MAGE-1mRNA and AFP mRNA in peripheral blood of patients with hepatocellular carcinoma: relationships with recurrence

Objective To detect MAGE-1 mRNA and AFP mRNA in the peripheral blood of patients with hepatocellular carcinoma(HCC) perioperatively, and explore their relationships with recurrence. Methods Peripheral blood from 45 patients with HCC, obtained perioperatively, was tested for the presence of MAGE-1mRNA and AFP mRNA by nested RT-PCR. All patients were followed for metastatic recurrence for average 11 months after surgery.The peripheral blood from 22 patients with hepatitis B and cirrhosis, 11 patients with hepatic hemangioma, 12 patients with metastatic liver cancer and 20 healthy volunteers served as control. Results Four of the twelve(33.3%) metastatic hepatic cancer patients were positive for MAGE-1mRNA, and three of the twenty-two(13.6%) patients with hepatitis B and cirrhosis were positive for AFPmRNA while the other controls kept negative in their peripheral blood. Detection rates for MAGE-1mRNA/AFPmRNA in the peripheral blood of patients with HCC were 42.2%/51.1% before operation, 20%/24.4% seven days after sugery, and 15.6%/22.2% 28 days later respectively. In chi-square analysis, detection of peripheral-blood MAGE-1 mRNA and AFPmRNA 28 days after surgery indicated metastatic recurrence. Furthermore, the two-marker detection had a higher specificity for prediction of metastatic recurrence than single marker detection. Conclusion Combined detection of cancer-specific MAGE-1 mRNA and hepatocyte-specific AFPmRNA by nested RT-PCR in the peripheral blood of patients with HCC 28 days after surgery may be useful for the prediction of metastatic recurrence.