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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

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【作者】 彭吉润赵力牟东成朱继业黄磊王东李澍冷希圣

【Author】 PENG Ji-run *,ZHAO Li, MU Dong-cheng ,ZHU Ji-ye,HUANG Lei,WANG Dong,LI Shu,LENG Xi-sheng. *Center of Hepatobiliary Surgery,Peking University People′s Hospital,Beijing 100044,China

【机构】 北京大学人民医院肝胆外科中心清华大学酒仙桥医院普通外科北京大学人民医院肝胆外科中心 100044100044

【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.

【基金】 国家自然科学基金资助项目 ( 3 0 2 0 0 2 71) ;卫生部部属(管)医疗机构临床学科重点项目 ( 2 0 0 1年 ) ;“十五”国家科技攻关计划资助项目 ( 2 0 0 1BA70 3B0 4) ;北京大学人类疾病基因研究中心科研基金资助项目 ( 2 0 0 1 6)
  • 【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
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