肝癌组织及外周血单核细胞端粒酶异常对肝癌诊断价值的研究

目的探讨肝癌组织及外周血单核细胞中端粒酶表达对肝癌诊断的临床价值。方法以0.05%2-乙基氨基芴(2-FAA)饲料饲养SD大鼠诱发肝癌发生,在肝细胞癌变过程中观察端粒酶的动态变化及与总RNA的关系。并从人肝癌和非癌组织中制备总RNA,采用端粒重复扩增法-ELISA分析肝组织及外周血单核细胞端粒酶活性及其对肝癌的诊断与鉴别价值。结果经大鼠诱癌后,在肝细胞经细胞变性、癌前病变和肝癌形成的过程中,肝内总RNA和端粒酶显著表达,并呈正相关关系(r=0.83,P<0.01);在人肝癌组端粒酶活性明显高于它的非癌组织,而总RNA则是非癌组明显高于癌组;外周血单核细胞中,癌组端粒酶活性明显高于肝硬化组、慢性肝炎组及正常对照(P<0.01);外周血AFP浓度与单核细胞端粒酶活性联合分析,对肝癌具有互补诊断价值。结论肝癌发生过程中端粒酶表达异常,外周血中端粒酶活性检测有助于肝癌的诊断及预后观察。

Diagnostic values of telomerase abnormality in hepatoma tissues and peripheral blood mononuclear cells for hepatocellular carcinoma

Objective To explore the clinical implications of telomerase expression in hepatoma and peripheral blood mononuclear cells(PBMCs) for hepatocellular carcinoma(HCC).Methods Rat hepatomas were induced by 2-fluorenylacetamide(2FAA,0.05%),the kinetic alterations of liver telomerase and total RNA were observed in the process of carcinogenesis of hepatocytes.Total RNAs were extracted from hepatomas and their non-cancerous tissues,the telomerase activities of livers and PBMCs were analyzed by TRAP-ELISA,and its clinical values were investigated in diagnosis and differentiation of HCC.Results The rat liver telomerase and total RNA were abnormally expressed,and both positive correlations(r=0.83, P<0.01) were found at the different stages of degeneration,precancerosis,and cancerization of rat hepatocytes.The expression of telomerase in human hepatomas was significantly higher than that in their non-cancerous tissues,but total RNA levels were lower in the former than that in the latter.The telomerase of PBMCs in HCC were much higher than those in liver cirrhosis,chronic hepatitis and control group(P<0.01),respectively.The combining analysis of circulating AFP and telomerase in PBMCs had complementary diagnostic values for HCC.Conclusions The tissue telomerase was overexpressed during development of HCC,and circulating telomerase could be a useful marker for diagnosis and prognosis of HCC