【摘要】 目的:探讨原发性肝细胞肝癌患者在肝移植术前外周血AFP mRNA的表达及其与术后肿瘤复发、患者预后的关系。方法:以2003年2月~2004年2月收入天津市第一中心医院的31例肝细胞肝癌行原位肝移植患者为研究对象,采用实时定量RT-PCR检测患者术前外周血AFP mRNA表达水平,均采用尸体供肝经典原位肝移植。以SPSS 12.0软件分析AFP mRNA的表达与患者术后肿瘤复发及生存的相关性。结果:31例患者中有10例AFP mRNA表达阳性,表达量为57~10 400 copy/μg,中位数为360 copy/μg。患者Child-pugh分级,肿瘤的大小、个数,病理Edmond分级与术前AFP mRNA的表达水平无关。肿瘤TNM分期为Ⅲ~Ⅳ期的患者AFP mRNA的阳性表达率显著高于Ⅰ~Ⅱ期患者(P=0.001);脉管浸润的患者AFP mRNA的表达水平显著高于无脉管浸润者(P=0.029)。肝移植术前AFP mRNA阴性组的无瘤生存及总体生存显著高于AFP mRNA阳性组。结论:术前AFP mRNA表达的水平是肿瘤复发的危险因素,是术前可能存在肝外微转移的指标,可作为预后的判断因子。更多还原

【Abstract】 Objective:To assess the relationship between pre-transplantation α-fetoprotein messenger(AFP) RNA expression in peripheral blood with tumor recurrence and survival rate in HCC patients.Methods: Thirty-one HCC patients receiving in situ liver transplantation from Feb.2003 to Feb.2004 were included in this study.Real-time quantitative RT-PCR was used to determine the expression level of AFP RNA in peripheral blood of all patients.All the cases were followed up for tumor recurrence and survival rate.The SPSS 12.0 software was used to analyze the relationship between AFP mRNA expression with tumor recurrence and survival rate.Results: Ten of the 31 patients were positive of AFP mRNA,with the quantity being 57 to 10 400 copies/μg RNA (median value: 360 copies/μg RNA).Patients’ Child-pugh grade,tumor size,tumor number,and tumor Edmond grade were not related to pre-transplantation AFP mRNA expression.Patients of pTNM Ⅲ-Ⅳ stages had a significantly higher AFP mRNA expression than those of pTNM Ⅰ-Ⅱ stages(P=0.001);patients with vascular invasion had a significantly higher expression than those without(P=0.029).Patients who were negative of AFP mRNA before transplantation had a significantly higher survival rate than those positive of AFP mRNA.Conclusion: The results suggest that the pre-transplantation levels of AFP mRNA in peripheral blood may be a risk factor for recurrence and/or metastasis after transplantation in HCC patients;it may also be an indicator for extra-hepatic micrometastasis before transplantation and can be used for predicting prognosis.更多还原