尿中修饰核苷检测在肝细胞性肝癌诊断中意义.docVIP

尿中修饰核苷检测在肝细胞性肝癌诊断中意义 　 【关键词】 核苷类，尿；癌，肝细胞；电泳，毛细管 Abstract: Objective: To investigate the value for detecting the modified nucleosides in urine for diagnosing the heaptocellular carcinoma. Methods: Four kinds of urinary nucleosides (M5U，I，Ac4c，X) from 21 preoperative and postoperative patients with primary heaptocellular carcinoma were detected. Ten cases with benign tumor of liver， 21 cases with cirrhosis of liver and 30 healthy persons were examined with high performance capillary electrophoresis(HPCE). Results: The average level of 4 kinds of nucleosides from preoperative patients with heaptocellular carcinoma was higher than that from postoperative patients with heaptocellular carcinoma (P lt;0.01). The average level of 4 kinds of nucleosides from patients with heaptocellular carcinoma was higher than that from patients with benign tumor of liver， patients with cirrhosis of liver and 30 healthy persons (P lt;0.05 or 0.01). The average level from patients with benign tumor of liver， patients with cirrhosis of liver and 30 healthy persons had no significant difference （P gt;0.05）. There was no significant correlation between the average level of 4 kinds of nucleosides and AFP（P gt;0.05）or the tumor size（P gt;0.05）. Conclusion: Urinary modified nucleosides may be helpful in diagnosing the heaptocellular carcinoma. The average level of 4 kinds of nucleosides has clinical significance in differentiating benign and malignant hepatic tumors. Key words: nucleosides，urine；carcinoma，hepatocellular；electrophoresis，capillary 修饰核苷是机体RNA代谢产物，RNA代谢产生正常核苷与修饰核苷，尿中修饰核苷的排量可以反映机体细胞的代谢速度。肿瘤细胞的增殖较正常细胞加快，导致修饰核苷的产生和排出增多。早期研究尿中修饰核苷需要收集24 h尿。Gehrke等[1]研究表明用“随机尿样”检测，以核苷含量(nmol)／肌酐(μmol)作为标准可取得与24 h尿样一样的结果，这大大方便了尿核苷的临床检测。近年来利用尿中修饰核苷作为恶性肿瘤的潜在诊断标记物已有报道[2-4]。本研究旨在探讨国人肝细胞性肝癌（HCC）患者与非HCC患者尿中修饰核苷的不同水平，了解其诊断HCC的灵敏度及特异度。探讨尿中修饰核苷与HCC肿瘤大小、AFP等的关系，并探讨HCC患者治疗前后尿中修饰核苷水平变化。 1 材料和方法 1.1 研究对象 HCC组:共21例，男19例，女2例，年龄34～76岁，平均（56.8±5.5）岁，均临床确诊并经手术后病理检查证实为HCC，均无远处转移。肝良性占位组:共10例，男4例，女6例，年龄33～74岁，平均（55.1±8.4）