肝癌血行相关因子及检测意义.docVIP

肝癌血行相关因子及检测意义 山东中医药大学2006级研究生刘奎 指导者 徐瑞荣 【摘要】早期微转移是肝癌难以有效诊治和病死率高的主要原因之一，因此早期检测出外周血中的肿瘤细胞，对及早有效的综合治疗具有重要的临床意义。血行微转移是肝癌的主要转移途径，但血行微转移的诊断仍然存在困难，主要是没有找到能准确反映早期微转移的肿瘤相关因子。近年来发现Glypican-3 mRNA、OPN、AFPmRNA、AFP-L3与肝癌血行微转移有密切的关系，而传统检测肝癌的标志物AFP、AFU、GGT2、AP、AIF、ALD-A、5’-NPDV、VEGF等依然在肝癌的检测中有着重要意义。现将目前肝癌血行检测的主要相关因子做一概述。 【关键词】 肝癌 血行相关因子 检测意义 Factors related primary carcinoma of the liver blood test and significance Liu Kui Guide XU Ruirong 【Abstract】Early micro-metastasis is the effective diagnosis and treatment of primary carcinoma of the liver and one of the main causes of high mortality, early detection of the tumor cells in peripheral blood of the early and effective treatment has important clinical significance. Blood-hepatocellular carcinoma metastasis is the main way to transfer, but the transfer of blood-diagnosis there are still difficulties, mainly find is not accurately reflect the early transfer of tumor-associated factor. In recent years found Glypican-3 mRNA, OPN, AFPmRNA, AFP-L3 blood and primary carcinoma of the liver micrometastases in a close relationship, and the traditional markers of primary carcinoma of the liver detection AFP, AFU, GGT2, AP, AIF, ALD-A, 5 - NPDV, VEGF, such as in primary carcinoma of the liver detection still has important significance. Presently makes the present primary carcinoma of the liver blood line of examinations main multiple coefficient of correlation an outline. 【Key words】primary carcinoma of the liver Blood related factors Examination significance 1. Glypican-3 mRNA 1.1 Glypican-3 mRNA的概述 Glypican-3即磷脂酰肌醇蛋白聚糖-3基因，是一种膜性硫酸乙酰肝素糖蛋白(HSPG)， Glypican-3结构特殊，影响多种生物效应分子，对组织、器官的发生、发展起关键的调节作用，几乎在所有人类肝癌和黑色素瘤细胞上表达，而在胎盘和胎肝以外的正常组织不表达。Glypican-3在肝癌中过表达,而在成人正常组织（如肝、肺、肾、心、脑、脾、胃、小肠、大肠、睾丸、膀胱及胰腺中亦均不表达［1］）、癌旁组织、肝炎、肝硬化组织中仅低表达或不表达。Zhu Z W等［2］证实Glypican-3 mRNA在正常肝组织、肝灶性结节状增生、肝硬化中低表达或不表达；相反在研究的30例肝癌患者中有20例显著表达，在5例中适度表达；Glypican-3在肝癌患者中相对于在正常肝组织中的表达平均增加有显著意义。Glypican-3被认为是肝癌表达比较特有的基因。 1.2 Glypican-3 mRNA的检测意义 柏凯等［3］通过检测原发性肝癌患者外周血Glypican-3，结