肝细胞癌高表达中期因子与肝癌细胞血行播散的关系

目的:探讨肝细胞癌(Hepatocellular Carcinoma,HCC)中期因子(Midkine,MK)蛋白高表达与肝癌细胞血行播散的可能关系.方法:应用RT-PCR和免疫组织化学染色方法分别检测AFP阳性HCC患者术前外周血AFP mRNA和手术切除肝癌组织MK蛋白,了解肝癌细胞血行播散和MK表达的情况,分析两者之间的相关性.结果:在41例HCC患者中,18例术前外周血可检出AFP mRNA,检出率为43.9%.在对应的肝癌组织中,29例高表达MK,表达率为70.7%.在29例高表达MK的HCC患者中,18例术前外周血AFP mRNA阳性,阳性率为62.1%:而在12例MK低表达的HCC患者中,仅3例术前外周血AFP mRNA阳性,阳性率为25.0%.两组之间差异有显著性(R＜0.05).结论:肝癌组织异常表达MK与外周血循环中存在肿瘤细胞有关,可能是肝癌细胞转移潜能的一个指标.

Correlation between Midkine Protein Overexpression in Hepatocellular Carcinoma with the Presence of Tumor Cells in the Blood Circulation

Objective: To investigate the midkine protein expression in human hepatocellular carcinoma (HCC) and its relation to cancer cell blood dissemination. Methods: Circulating tumor cells were detected in preoperative blood samples using reverse transciption polymerase chain reaction (RT-PCR) for alpha-fetoprotein (AFP) mRNA. Midkine expression was immunohistochemically examined on surgically resected HCC tissues. Results: Fortyone HCC patients with serum AFP positive were studied. Positive AFP mRNA expression was showed in 18 preoperative blood samples (43.9%) and midkine overexpression was detected in 29 excised tumors (70.7%). Among the 29 patients, 18 (62.1%) showed AFP mRNA positive in their pre-operative blood samples. In contrast, the positive AFP mRNA expression was only observed in 3 out of 12 patients (25.0%) without aberrant midkine expression. Statistical analysis showed that abnormal midkine expression in the tumors was a varial significantly associated with the presence of tumor cells in the blood circulation (P<0.05). Conclusion: In human hepatocellular carcinoma, midkine overexpression is correlated with a haematogenuous spread of the primary tumor cells, may be a marker of tumor metastatic potential.