• 1.華中科技大學(xué)同濟醫(yī)學(xué)院附屬同濟醫(yī)院肝臟外科中心（武漢430030）;;
  • 2.華中科技大學(xué)同濟醫(yī)學(xué)院附屬同濟醫(yī)院臨床免疫室;

目的  探討手術(shù)操作是否會導(dǎo)致肝癌細胞的血行播散。方法  選擇14例無遠處轉(zhuǎn)移并行肝癌切除術(shù)的肝癌患者，提取患者術(shù)前和術(shù)后外周血標本，于術(shù)中腫瘤切除后提取門靜脈和肝靜脈血標本。采用巢式RT-PCR方法檢測血中AFP-mRNA的表達，觀察手術(shù)前后血液中AFP-mRNA表達陽性率及表達水平的變化。 結(jié)果  術(shù)前外周血、手術(shù)切除腫瘤后門靜脈血和術(shù)后外周血中AFPmRNA表達陽性率分別為42.9%，42.9%和35.7%，術(shù)中切除腫瘤后肝靜脈血中的表達陽性率為57.1%，雖高于前三者，但無統(tǒng)計學(xué)差異，但AFP-mRNA表達水平明顯高于術(shù)前及術(shù)后外周血和術(shù)中門靜脈血（P＜0.05）。結(jié)論  手術(shù)中有包括肝癌細胞在內(nèi)的肝臟來源的細胞經(jīng)肝靜脈進入血循環(huán)。

引用本文： 趙鴻,陳孝平,趙西平,楊東亮. 肝癌患者手術(shù)前后血液中AFP-mRNA的變化及意義. 中國普外基礎(chǔ)與臨床雜志, 2001, 8(6): 403-405. doi: 復(fù)制

1. Smith B, Selby P, Southgate J, et al. Detection of melanoma cells in peripheral blood by means of reverse transcriptase and polymerase chain reaction 〔Ｊ〕. Lancet, 1991; 338(8777)∶1227.
2. Naito H, Kuzumaki N, Uchino J, et al. Detection of tyrosine hydroxylase mRNA and minimal neuroblastoma cells by the reverse transcriptionpolymerase chain reaction 〔Ｊ〕. Eur J Cancer, 1991; 27(6)∶762.
3. Carr BI, Kar S. An assay for hepatoma micrometastasis: albumin gene expression in peripheral blood from patients with advanced hepatocellular carcimona (HCC) 〔Ｊ〕. Hepatology, 1991; 14(1)∶108A.
4. Brown DC, Purushotham AD, Birnie GD, et al. Detection of intraoperative tumor cell dissemination in patients with breast cancer by use of reverse transcription and polymerase chain reaction 〔Ｊ〕. Surgery, 1995; 117(1)∶96.
5. Glaves D, Huben RP, Weis L. Hematogenous dissemination of cells from human renal adenocarcinomas 〔Ｊ〕. Br J Cancer, 1988; 57(1)∶32.
6. Leather AJ, Gallegos NC, Kocjan G, et al. Detection and numeration of circulating tumor cells in colorectal cancer 〔Ｊ〕. Br J Surg, 1993; 80(6)∶777.
7. Moreno JG, Groce CM, Fischer R, et al. Detection of hematogenous micrometastasis in patients with prostate cancer 〔Ｊ〕. Cancer Res, 1992; 52(21)∶6110.
8. Louha M, Poussin K, Ganne N, et al. Spontaneous and latrogenic sprending of liverderived cells into peripheral blood of patients with primary liver cancer 〔Ｊ〕. Hepatology, 1997; 26(4)∶998.
9. Naoto O, Akimasa N, Shin T, et al. Clinical significance of αfetoprotein mRNA during perioperative period in HCC 〔Ｊ〕. Hepatogastrienterology, 1999; 46(25)∶381.
10. Malek L, Jerome N, Herve Z, et al. Liver resection and needle biopsy cause hematogenous dissemination of liver cells 〔Ｊ〕. Hepatology, 1999; 29(4)∶ 879.
11. Lemoine A, Le Bricon T, Salvucci M, et al. Prospective evaluation of circulating hepatocytes by alphafetoprotein mRNA in humans during liver surgery 〔Ｊ〕. Ann Surg, 1997; 226(1)∶43.
12. Esteban C, Trojan J, Macho A, et al. Activation of an alphafetoprotein or receptor pathway in human normal and malignant peripheral blood mononuclear cells 〔Ｊ〕. Leukemia，1993; 7(11)∶1807.
  1. 1. Smith B, Selby P, Southgate J, et al. Detection of melanoma cells in peripheral blood by means of reverse transcriptase and polymerase chain reaction 〔Ｊ〕. Lancet, 1991; 338(8777)∶1227.
  2. 2. Naito H, Kuzumaki N, Uchino J, et al. Detection of tyrosine hydroxylase mRNA and minimal neuroblastoma cells by the reverse transcriptionpolymerase chain reaction 〔Ｊ〕. Eur J Cancer, 1991; 27(6)∶762.
  3. 3. Carr BI, Kar S. An assay for hepatoma micrometastasis: albumin gene expression in peripheral blood from patients with advanced hepatocellular carcimona (HCC) 〔Ｊ〕. Hepatology, 1991; 14(1)∶108A.
  4. 4. Brown DC, Purushotham AD, Birnie GD, et al. Detection of intraoperative tumor cell dissemination in patients with breast cancer by use of reverse transcription and polymerase chain reaction 〔Ｊ〕. Surgery, 1995; 117(1)∶96.
  5. 5. Glaves D, Huben RP, Weis L. Hematogenous dissemination of cells from human renal adenocarcinomas 〔Ｊ〕. Br J Cancer, 1988; 57(1)∶32.
  6. 6. Leather AJ, Gallegos NC, Kocjan G, et al. Detection and numeration of circulating tumor cells in colorectal cancer 〔Ｊ〕. Br J Surg, 1993; 80(6)∶777.
  7. 7. Moreno JG, Groce CM, Fischer R, et al. Detection of hematogenous micrometastasis in patients with prostate cancer 〔Ｊ〕. Cancer Res, 1992; 52(21)∶6110.
  8. 8. Louha M, Poussin K, Ganne N, et al. Spontaneous and latrogenic sprending of liverderived cells into peripheral blood of patients with primary liver cancer 〔Ｊ〕. Hepatology, 1997; 26(4)∶998.
  9. 9. Naoto O, Akimasa N, Shin T, et al. Clinical significance of αfetoprotein mRNA during perioperative period in HCC 〔Ｊ〕. Hepatogastrienterology, 1999; 46(25)∶381.
  10. 10. Malek L, Jerome N, Herve Z, et al. Liver resection and needle biopsy cause hematogenous dissemination of liver cells 〔Ｊ〕. Hepatology, 1999; 29(4)∶ 879.
  11. 11. Lemoine A, Le Bricon T, Salvucci M, et al. Prospective evaluation of circulating hepatocytes by alphafetoprotein mRNA in humans during liver surgery 〔Ｊ〕. Ann Surg, 1997; 226(1)∶43.
  12. 12. Esteban C, Trojan J, Macho A, et al. Activation of an alphafetoprotein or receptor pathway in human normal and malignant peripheral blood mononuclear cells 〔Ｊ〕. Leukemia，1993; 7(11)∶1807.