Department of Pathophysiological and Therapeutic Science, Tottori University, Japan.
BMC Gastroenterol. 2010 May 18;10:46. doi: 10.1186/1471-230X-10-46.
We previously reported a highly sensitive method for serum human telomerase reverse transcriptase (hTERT) mRNA for hepatocellular carcinoma (HCC). alpha-fetoprotein (AFP) and des-gamma-carboxy prothrombin (DCP) are good markers for HCC. In this study, we verified the significance of hTERTmRNA in a large scale multi-centered trial, collating quantified values with clinical course.
In 638 subjects including 303 patients with HCC, 89 with chronic hepatitis (CH), 45 with liver cirrhosis (LC) and 201 healthy individuals, we quantified serum hTERTmRNA using the real-time RT-PCR. We examined its sensitivity and specificity in HCC diagnosis, clinical significance, ROC curve analysis in comparison with other tumor markers, and its correlations with the clinical parameters using Pearson relative test and multivariate analyses. Furthermore, we performed a prospective and comparative study to observe the change of biomarkers, including hTERTmRNA in HCC patients receiving anti-cancer therapies.
hTERTmRNA was demonstrated to be independently correlated with clinical parameters; tumor size and tumor differentiation (P < 0.001, each). The sensitivity/specificity of hTERTmRNA in HCC diagnosis showed 90.2%/85.4% for hTERT. hTERTmRNA proved to be superior to AFP, AFP-L3, and DCP in the diagnosis and underwent an indisputable change in response to therapy. The detection rate of small HCC by hTERTmRNA was superior to the other markers.
hTERTmRNA is superior to conventional tumor markers in the diagnosis and recurrence of HCC at an early stage.
我们之前报道了一种检测血清人端粒酶逆转录酶（hTERT）mRNA 用于诊断肝细胞癌（HCC）的高敏感方法。甲胎蛋白（AFP）和脱γ-羧基凝血酶原（DCP）是 HCC 的良好标志物。在这项研究中，我们通过大样本多中心试验，对 hTERTmRNA 进行了量化，并与临床病程进行了比较，验证了其在 HCC 诊断中的意义。
在包括 303 例 HCC 患者、89 例慢性肝炎（CH）患者、45 例肝硬化（LC）患者和 201 例健康对照者的 638 例受试者中，我们使用实时 RT-PCR 检测血清 hTERTmRNA。我们检测了 hTERTmRNA 在 HCC 诊断中的敏感性和特异性，与其他肿瘤标志物的比较，ROC 曲线分析，以及与临床参数的相关性，采用 Pearson 相关检验和多因素分析。此外，我们进行了一项前瞻性的比较研究，观察包括 hTERTmRNA 在内的生物标志物在接受抗癌治疗的 HCC 患者中的变化。
hTERTmRNA 被证明与临床参数独立相关；肿瘤大小和肿瘤分化（P < 0.001，各）。hTERTmRNA 对 HCC 的诊断敏感性/特异性为 90.2%/85.4%。hTERTmRNA 在诊断和治疗反应方面优于 AFP、AFP-L3 和 DCP。hTERTmRNA 检测小 HCC 的检出率优于其他标志物。
hTERTmRNA 在 HCC 的早期诊断和复发方面优于传统肿瘤标志物。
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