摘要
目的 比较和评估手术切除和微波固化两种治疗方法对肝癌细胞血行性播散的影响。方法 应用巢式RT PCR检测治疗前外周血AFP mRNA、MAGE 1 mRNA和MAGE 3 mRNA表达均为阴性的92例TNMⅡ期原发性肝癌(HCC)患者及10例良性肝病患者治疗后外周血上述指标的表达情况。结果 直径≤3cm的TNMⅡ期HCC微波治疗后外周血AFP mRNA、MAGE 1 mR NA和MAGE 3 mRNA表达总阳性率为4 35%(1/23),手术治疗后总阳性率为30 43%(7/23),两组比较差异显著(P<0 05)。直径>3cm的TNMⅡ期HCC微波治疗后外周血AFP mRNA、MAGE 1 mRNA和MAGE 3 mRNA表达总阳性率为21 7%(5/23),手术治疗后总阳性率为34 8%(8/23),两组比较无显著性差异(P>0 05)。对照组三项指标检测均为阴性。结论 手术与微波治疗均可能导致医源性癌细胞血行播散,直径≤3cm的TNMⅡ期HCC微波治疗引起的肝癌细胞血行性播散概率较手术治疗低,但对直径>3cm的TNMⅡ期HCC而言,两种方法无明显差异。
Objective To compare and assess the effect of surgical resection(SR) and microwave coagulation therapy(MCT) on the treatments of hepatocellular carcinoma(HCC) correlated to HCC cell hematogenous dissemination. Methods Nested RT PCR was employed on 92 HCC patients (TNM pStage Ⅱ) and 10 benign hepatopathies, for whom all the AFP mRNA, MAGE 1 mRNA and MAGE 3 mRNA were negative, to detect the changes of above targets in peripheral blood before and after SR and MCT. Results For the HCC patients (TNM pStage Ⅱ, tumor diameter ≤3cm), after MCT the AFP mRNA expressed in only one case, MAGE 1 mRNA and MAGE 3 mRNA were not expressed in any of them, the total positive rate was 4 3%(1/23), while after SR the total positive rate (at least one gene was detected) was 30 43%(7/23), significantly higher than that of MCT group ( P <0 05). For those patients whose tumor diameter > 3cm the total positive expression of AFP mRNA, MAGE 1 mRNA and MAGE 3 mRNA was 21 7%(5/23) after MCT and 34 8%(8/23) after SR. Conclusion Both the therapy (SR and MCT) may cause the iatrogenic HCC cell hematogenous dissemination. When the tumor diameter ≤3cm the dissemination probability in the patients with TNM pStage Ⅱ was lower by MCT than by SR, but no significant difference existed between the both therapy when the tumor diameter >3cm.
出处
《解放军医学杂志》
CAS
CSCD
北大核心
2005年第6期539-541,共3页
Medical Journal of Chinese People's Liberation Army
关键词
癌
肝细胞
肝切除术
微波同化
血行性播散
肿瘤循环细胞
carcinoma, hepatocellular
hepatectomy
microwave coagulation
hematogenous dissemination
neoplasm circulating cells
