DETECTION OF LIVER-CELLS IN PERIPHERAL-BLOOD OF PATIENTS WITH ADVANCED-STAGE HEPATOCELLULAR-CARCINOMA
DETECTION OF LIVER-CELLS IN PERIPHERAL-BLOOD OF PATIENTS WITH ADVANCED-STAGE HEPATOCELLULAR-CARCINOMA
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DOI：
10.1016/0270-9139(95)90100-0
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发表时间：
1995-02-01
期刊：
影响因子：
13.5
通讯作者：
CARR, BI
中科院分区：
文献类型：
--
作者：
KAR, S;CARR, BI
大部分晚期肝细胞癌（HCC）患者在原发性切除术后甚至原位肝移植术后，肝脏或肺部肿瘤复发。其中一个原因可能是手术前血液中存在少量肿瘤细胞循环或手术操作期间肿瘤细胞释放到循环中。我们用高灵敏度的逆转录聚合酶链反应（RT-PCR）技术检测了作为肝细胞标志物的人白蛋白基因的信使RNA（mRNA），以验证这一假设。在正常人（0/6）、肝硬化患者（0/10）、其他肝转移肿瘤（0/10）或肝硬化肝移植手术期间（0/10）的外周血中未发现白蛋白mRNA。在晚期HCC患者中（TNM分期III.和IV），外周血中检测到白蛋白mRNA（16/17）。肝癌患者肝移植后，mRNA水平下降到检测限以下（0/9）。其中三名患者在肝移植后HCC复发时再次检测到mRNA水平。I期HCC患者未检测到表达。这些结果表明，循环肿瘤细胞存在于晚期HCC患者中，这可能是这些患者在明确的手术切除甚至肝移植后肿瘤复发率高的原因之一。
A large percentage of patients with advanced-stage hepatocellular carcinoma (HCC) have a recurrence of tumor in the liver or lung after primary resection and even after orthotopic liver transplantation. One reason for this may be the presence of small numbers of tumor cells circulating in the blood before surgery or the liberation of tumor cells into circulation during surgical manipulation. We tested this hypothesis by measuring messenger RNA (mRNA) for human albumin gene as a liver cell marker with the highly sensitive reverse transcriptase polymerase chain reaction (RT-PCR) technique. Albumin mRNA was not found in peripheral blood from normal humans (0 of 6), from patients with liver cirrhosis (0 of 10), from other tumors metastatic to liver (0 of 10), or during liver transplant surgery for cirrhosis (0 of 10). In patients with advanced-stage HCC (TNM stages III. and IV), albumin mRNA was detected (16 of 17) in peripheral blood. After liver transplantation in the HCC patients, the level of mRNA decreased below the detectable limit (0 of 9). Three of these patients again had detectable mRNA levels when they had recurrence of HCC after liver transplantation. Patients with stage I HCC did not have detectable expression. These results suggest that circulating tumor cells are present in patients with advanced-stage HCC, which may be one of the reasons why these patients have a high incidence of tumor recurrence after apparently definitive surgical resection and even after liver transplantation.