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目的探讨肿瘤播散细胞检测对肝癌肝移植术中转移的评价意义以及与基质金属蛋白水解酶(MMP-9)、黏附分子(CD44v6)的相关性。方法采用RT-PCR联合荧光标记探针杂交法定量检测30例血清AFP阳性肝癌肝移植患者术前、术中播散肿瘤细胞AFPmRNA表达水平,ELISA法检测肝癌肝移植术前患者血清CD44v6水平,免疫组化法检测MMP9在肿瘤组织中的表达;运用统计软件SPSS9.0行χ2检验、方差分析和t检验。结果30例肝癌肝移植术中肿瘤播散阳性率肺动脉、外周动脉、外周静脉、门静脉分别为63.3%、60%、50%、40%;肝移植手术过程中对肝脏的挤压可以引起肿瘤播散,并且以肺动脉途径为主,P<0.01;术中肿瘤播散组与无肿瘤播散组血清CD44v6水平差异有显著性,P<0.01;术中肿瘤播散组与无术中肿瘤播散组肿瘤组织表达MMP9差异有显著性,P<0.05。结论RT-PCR联合荧光标记探针杂交法能够检测到肝癌患者血液中播散肿瘤细胞,并且以肺动脉血阳性率最高;在肝移植过程中对病肝的搬动、挤压可以引起肿瘤细胞播散;其过程与基质金属蛋白水解酶(MMP-9),黏附分子(CD44v6)相关。
Objective To investigate the significance of the detection of tumor-disseminated cells in the metastasis of liver cancer and the correlation with matrix metalloproteinases (MMP-9), adhesion molecules (CD44v6). Methods The levels of AFP mRNA were detected by RT-PCR and fluorescence labeled probe hybridization in 30 cases of AFP positive hepatocellular carcinoma before and during the operation. The level of CD44v6 in serum of patients with liver cancer before liver transplantation was detected by ELISA, The expression of MMP9 in tumor tissue was detected by histochemical method. The χ2 test, ANOVA and t-test were performed using statistical software SPSS9.0. Results The positive rates of tumor dissemination in 63 cases of liver cancer with liver transplantation were 63.3%, 60%, 50% and 40%, respectively. The compression of the liver during liver transplantation caused tumor sowing (P <0.01). There was a significant difference in serum CD44v6 level between the tumor-spread group and the tumor-free group (P <0.01), and the difference was statistically significant There was a significant difference in the expression of MMP9 between the two groups (P <0.05). Conclusion RT-PCR combined with fluorescent-labeled probe hybridization can detect the spread of tumor cells in the blood of patients with hepatocellular carcinoma, and the highest positive rate of pulmonary arterial blood; liver transplantation during liver transplantation, extrusion can cause tumor cell sowing Scattered; its process and matrix metalloproteinases (MMP-9), adhesion molecules (CD44v6) related.