Shi Ming, Zhang Ying, Zhong Chong, Lin Xiao-Jun, Zhang Chang-Qing, Li Jin-Qing
State Key Laboratory of Oncology in South China, Guangzhou, Guangdong, PR China.
Ai Zheng. 2008 Jan;27(1):83-7.
BACKGROUND & OBJECTIVE: Alpha-fetoprotein (AFP) is a marker often used to detect carcinoma cells in peripheral blood of patients with hepatocellular carcinoma (HCC). This study was to explore the correlation of perioperative AFP expression in peripheral blood to recurrence of HCC.
Peripheral blood samples from 56 HCC patients, obtained perioperatively, were tested for the presence of AFP mRNA by nested reverse transcription-polymerase chain reaction (RT-PCR) and TaqMan MGB probe real-time quantitative PCR. The peripheral blood samples from 15 patients with benign liver masses and cirrhosis, and 30 healthy volunteers were used as control.
The positive rate of AFP mRNA in preoperative peripheral blood was significantly higher in HCC patients than in patients with benign liver masses and cirrhosis (42.9% vs. 13.3%, P=0.035) and healthy volunteers (42.9% vs. 10.0%,P=0.002). The expression of AFP mRNA in preoperative peripheral blood was significantly related to tumor vascular invasion, either observed macroscopically (P=0.029) or microscopically (P<0.001). The 1-, 2-, and 3-year overall and disease-free survival rates were significantly higher in AFP-negative patients than in AFP-positive patients (P=0.003, P=0.039). Cox multivariate analysis showed that preoperative expression of AFP mRNA in peripheral blood was an independent factor for predicting recurrence (P=0.018). The positive rate of AFP mRNA in postoperative peripheral blood samples from HCC patients was 37.5%. The presence of AFP mRNA in postoperative peripheral blood was not related to any clinicopathologic factors, AFP mRNA levels in preoperative peripheral blood, and prognosis of the HCC patients.
The presence of AFP mRNA in preoperative peripheral blood is related to tumor invasion of HCC, and may be a predictor maker of tumor recurrence.
甲胎蛋白（AFP）是常用于检测肝细胞癌（HCC）患者外周血中癌细胞的标志物。本研究旨在探讨外周血围手术期AFP表达与HCC复发的相关性。
采用巢式逆转录聚合酶链反应（RT-PCR）和TaqMan MGB探针实时定量PCR检测56例HCC患者围手术期采集的外周血样本中AFP mRNA的存在情况。将15例良性肝肿块和肝硬化患者以及30例健康志愿者的外周血样本作为对照。
HCC患者术前外周血中AFP mRNA的阳性率显著高于良性肝肿块和肝硬化患者（42.9%对13.3%，P=0.035）和健康志愿者（42.9%对10.0%，P=0.002）。术前外周血中AFP mRNA的表达与肿瘤血管侵犯显著相关，无论是宏观观察（P=0.029）还是微观观察（P<0.001）。AFP阴性患者的1年、2年和3年总生存率及无病生存率显著高于AFP阳性患者（P=0.003，P=0.039）。Cox多因素分析显示，术前外周血中AFP mRNA的表达是预测复发的独立因素（P=0.018）。HCC患者术后外周血样本中AFP mRNA的阳性率为37.5%。术后外周血中AFP mRNA的存在与任何临床病理因素、术前外周血中AFP mRNA水平及HCC患者的预后均无关。
术前外周血中AFP mRNA的存在与HCC的肿瘤侵犯有关，可能是肿瘤复发的预测指标。
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