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以肿瘤-睾丸抗原mRNA为特异性标记评价肝癌患者肝移植的预后
Use of cancer-testis antigen mRNA as specific markers to evaluate the prognosis of patients with hepatocellular carcinoma undergoing liver transplantation
【摘要】 目的探讨肝细胞癌 (hepatocellularcarcinoma ,HCC)患者原位肝移植 (orthotopiclivertrans plantation ,OLT)手术前后外周血中MAGE 1、SSX1及CTp11基因mRNA表达与预后的关系。方法用巢式RT PCR方法检测OLT手术前后外周血单个核细胞 (PBMC)中上述 3种基因的表达 ,并对 2 6例患者进行随访。结果HCC患者术前PBMC中MAGE 1、SSX1和CTp11基因mRNA的表达率分别为4 0 0 % (14 / 35 )、37 1% (13/ 35 )和 31 4 % (11/ 35 ) ,6 0 0 % (2 1/ 35 )患者的PBMC中至少可以检测到其中一种基因表达。 16例术前PBMC中检测到上述基因表达者 ,术后肿瘤复发 /转移率 (75 0 % )显著高于10例不表达这 3种基因者 (30 0 % ) (P =0 0 4 3) ;在术前及术后这 3种基因mRNA持续呈阳性或者由阴性转为阳性的 2 0例患者中 ,15例 (75 0 % )术后发生肿瘤复发 /转移 ,而 3种基因mRNA持续阴性或者由阳性转为阴性的 6例患者无 1例复发 /转移 (P =0 0 0 2 )。结论MAGE 1、SSX1及CTp11基因mR NA可以联合作为肿瘤特异性标志物用于检测HCC患者血循环中的肿瘤细胞 ,并有助于选择OLT受体及判断预后。
【Abstract】 Objective To investigate the relationship between the expression of MAGE-1,SSX-1,and CTp11 mRNA in the peripheral blood of patients with hepatocellular carcinoma (HCC) receiving orthotopic liver transplantation (OLT) and the prognosis of these patients. [WT5”HZ]Methods The expression of the three genes in the peripheral blood mononuclear cells (PBMCs) was detected by nested RT-PCR,and a follow-up was carried out in 26 patients. Results Before OLT,the positive rate of MAGE-1,SSX-1 and CTp11 transcripts was 40.0% (14/35),37.1% (13 /34),and 31.4% (11/35),respectively in the PBMC samples of HCC patients;Sixty percent (21/35) of the PBMC samples were positive for at least one of the three gene transcripts. The follow-up of 26 patients showed that,the tumor recurrence/metastasis rate after OLT (75.0%) in 16 patients with positive preoperative PBMC samples of at least one gene transcripts was significantly higher than that of the other 10 patients who was negative preoperatively for gene transcripts (30.0%)( P = 0.043).Postoperative tumor recurrence or metastasis developed in 15 out of 20(75%) patients with persistently perioperative positive MAGE-1,SSX-1 and /or CTp11 transcripts in PBMC samples or swithing from negative to positive perioperatively,in contrast to no recurrence nor metastasis in the other 6 patients with the gene transcripts switching from positive to negative postoperatively,or negative perioperatively ( P =0.002). [WT5”HZ]Conclusions MAGE-1,SSX-1 and CTp11 transcripts may act as combined tumor-specific makers to detect tumor cells in the peripheral circulation of HCC patients,and the detection is valuable for selecting OLT candidates and predicting the postoperative prognosis.
【Key words】 Carcinoma, hepatocellular; Liver transplantation; nested RT-PCR; mRNA; Prognosis;
- 【文献出处】 中华普通外科杂志 ,Chinese Journal of General Surgery , 编辑部邮箱 ,2004年08期
- 【分类号】R735.7
- 【被引频次】9
- 【下载频次】132