摘要
BACKGROUND:Hepatocellular carcinoma(HCC)is one of the most common malignant tumors worldwide,its prognosis is poor,and early detection is of utmost importance.Although alpha-fetoprotein(AFP)is a useful marker for detecting and monitoring HCC development,the false-negative or false-positive rates with AFP alone may be as high as 30%-40%for patients with small HCCs.To enhance the specificity and accuracy of AFP measurements for HCC,we analyzed AFP expression states in livers,detected the hepatoma-specific AFP(HS-AFP)fraction and AFP-mRNA from peripheral blood mononuclear cells,and explored their clinical implications for HCC diagnosis.METHODS:AFP expression and hepatocyte distributions in liver specimens were investigated by an immunohistoche-mical assay.Total RNAs were extracted from circulating blood,synthesized to cDNA through random primers and reverse transcriptase,and fragments of the AFP gene were amplified by a nested-PCR assay.The HS-AFP fraction was separated by lectin-affinity chromatography and its level was detected by radioimmunoassay.RESULTS:The incidence of AFP was 73.3%in HCC tissues and its expression in HCCs with moderate or low differentiation was significantly stronger than that of HCCs with high differentiation(P<0.05).The incidence of AFP gene fragments was 100%in HCCs,and 60%in paracancerous tissues(P<0.01).In the HCC and liver cirrhosis groups,the incidence of HS-AFP was 91.7%and 18%(P<0.01),and of AFP-mRNA was 56.7%and 16%(P<0.01),respectively,and neither was found in controls.HS-AFP or AFP-mRNA was not significantly related to size or number of HCC,but to its differentiation,metastasis,and relapse(P<0.05).CONCLUSIONS:Different AFP expression is present in different parts of HCC tissues.HS-AFP and AFP-mRNA fragments improve sensitivity and specificity,and both are useful markers to diagnose HCC or monitor metastasis and relapse.
基金
This study was supported in part by a grant from the Project of the Bureau of Science and Technology,Nantong(s30033),China.
