Yang Shi-Zhong, Dong Jia-Hong, Li Kun, Zhang Yu, Zhu Jin
Southwest Hepatobiliary Hospital & Institute of Hepatobiliary Surgery, Southwest Hospital, Third Military Medical University, Chongqing 400038, China.
Hepatobiliary Pancreat Dis Int. 2005 May;4(2):227-33.
The highly sensitive technique of reverse transcriptase-polymerase chain reaction(RT-PCR) has been used to detect circulating tumor cells. This study was undertaken to detect circulating hepatocellular carcinoma cells and to evaluate their potential clinical implication in HCC patients.
Subjects included 65 patients with primary HCC, 22 patients with hepatitis B and liver cirrhosis, 12 patients with metastatic liver cancer, 11 patients with hepatic hemangioma, and 20 healthy volunteers. AFPmRNA and melanoma antigen gene (MAGE-1) mRNA in peripheral blood samples were tested using nested RT-PCR.
The positive rates of MAGE-1mRNA and AFPmRNA were 41.5% (27) and 53.8%(35), respectively in the HCC patients. In 64.6%(42) of the 65 patients, there was at least one positive marker. The positive rate of AFPmRNA or MAGE-1mRNA was correlated with portal thrombosis, nodules of tumor, tumor diameter and TNM stage (P<0.05). Samples from 4 (33.3%) of the 12 patients with metastatic liver cancer were MAGE-1mRNA positive, samples from 3(13.6%) of the 22 patients with cirrhosis AFPmRNA positive, and the others were both negative.
Nested RT-PCR is a sensitive and reliable method for detecting circulating HCC cells. A two-marker RT-PCR assay with a liver-specific AFP marker and a cancer specific MAGE-1 marker may be a promising tool for detecting blood disseminated HCC cells with a better sensitivity and specificity than a single marker RT-PCR.
逆转录-聚合酶链反应（RT-PCR）这一高灵敏度技术已用于检测循环肿瘤细胞。本研究旨在检测循环中的肝癌细胞，并评估其在肝癌患者中的潜在临床意义。
研究对象包括65例原发性肝癌患者、22例乙肝肝硬化患者、12例转移性肝癌患者、11例肝血管瘤患者以及20名健康志愿者。采用巢式RT-PCR检测外周血样本中的甲胎蛋白信使核糖核酸（AFPmRNA）和黑色素瘤抗原基因（MAGE-1）信使核糖核酸。
肝癌患者中MAGE-1mRNA和AFPmRNA的阳性率分别为41.5%（27例）和53.8%（35例）。65例患者中有64.6%（42例）至少有一项阳性标志物。AFPmRNA或MAGE-1mRNA的阳性率与门静脉血栓形成、肿瘤结节、肿瘤直径及TNM分期相关（P<0.05）。12例转移性肝癌患者中有4例（33.3%）样本MAGE-1mRNA呈阳性，22例肝硬化患者中有3例（13.6%）样本AFPmRNA呈阳性，其余均为阴性。
巢式RT-PCR是检测循环肝癌细胞的一种灵敏且可靠的方法。采用肝脏特异性AFP标志物和癌症特异性MAGE-1标志物的双标志物RT-PCR检测法，可能是一种有前景的检测血液中播散性肝癌细胞的工具，其灵敏度和特异性优于单标志物RT-PCR。
