目的通过对原发性肝细胞癌（ＨＣＣ）外周血中癌细胞的检测，为临床建立诊断肝癌转移的常规方法．．方法以甲胎蛋白（ＡＦＰ）ｍＲＮＡ为ＨＣＣ的标记物，应用ｎｅｓｔｅｄＲＴＰＣＲ对３０例ＨＣＣ外周静脉全血标本及不同细胞株进行检测及分析．结果ＨＣＣ患者３０例外周血癌细胞阳性检出率为５６７％，并与肝内静脉癌栓形成（１１／１３，８４６％ｖｓ６／１７，３５３％）、肝内转移（１６／２３，６９６％ｖｓ１／７，１４３％）和细胞分化密切相关（Ｐ＜００５）；最低检出浓度为全血肝癌细胞２×１０４／Ｌ．对照组中结肠癌、鼻咽癌等肝转移癌以及胆囊结石患者的外周血中均未发现ＡＦＰｍＲＮＡ．结论ＮｅｓｔｅｄＲＴＰＣＲ对ＨＣＣ的检测具有较强的特异性和较高的灵敏度，对于ＨＣＣ诊断、判断转移可能具有较为重要的临床应用价值 Objective To establish a routine method for the diagnosis of metastasis of hepatocellular carcinoma by detecting cancer cells in peripheral blood of primary hepatocellular carcinoma (HCC). . Methods The alpha fetoprotein (AFP) mRNA was used as a marker of HCC. Nested RTPCR was used to detect and analyze 30 cases of HCC peripheral blood whole blood samples and different cell lines. Results The positive rate of 30 cases of peripheral blood cancer cells in HCC patients was 56.7%, and it was associated with intrahepatic vein tumor thrombosis (11/13, 846% vs6/17, 353%), intrahepatic metastasis (16 /23,696%vs1/7,143%) was closely related to cell differentiation (P<005); the lowest detection concentration was 2×104/L for whole blood hepatoma cells. No AFP mRNA was detected in the peripheral blood of patients with colon cancer, nasopharyngeal carcinoma, and gallbladder stones in the control group. Conclusion Nested RTPCR has high specificity and high sensitivity in the detection of HCC. It may have important clinical application value for the diagnosis and judgment of metastasis of HCC.