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目的:探讨血浆DNA和HBV-DNA载量在病毒性肝炎肝硬化后原发性肝癌(PHC)的诊断价值。方法:用RT-PCR方法随访检测HBsAg阳性且经彩色B超诊断为肝硬化的患者,每6个月检测一次患者的血液循环DNA和HBV-DNA载量,直到经临床症状、彩色B超、CT诊断为原发性肝癌为止。结果:在PHC中,循环DNA 61.3±31.9ng/ml,健康对照组20.3±9.9ng/ml,两组差异显著(P<0.01);而HBV-DNA载量,在PHC确诊时多数处于较低水平,78%≤105copies/ml,与PHC确诊前有明显差异(P<0.01)。PHC未发生淋巴结转移者循环DNA 51.2±17.9ng/ml,淋巴结转移者循环DNA 73.9±23.7ng/ml,两者存在差异(P<0.05);而HBV-DNA载量有无淋巴结转移无明显差异。结论:联合检测血液循环DNA和HBV-DNA载量对PHC的预测、预后价值明显,且方法简单,易于开展。
Objective: To investigate the diagnostic value of plasma DNA and HBV DNA load in patients with primary liver cancer (PHC) after viral hepatitis and cirrhosis. Methods: The blood DNA and HBV DNA load of HBsAg positive patients who were diagnosed as cirrhosis by color B ultrasound were detected by RT-PCR method every 6 months. Until clinical symptoms, color B ultrasound, CT diagnosis of primary liver cancer so far. Results: In PHC, circulating DNA 61.3 ± 31.9ng / ml, healthy control group 20.3 ± 9.9ng / ml, significant difference between the two groups (P <0.01); and HBV-DNA load, most of the PHC diagnosis was at a lower Level, 78% ≤105copies / ml, there was a significant difference with PHC before diagnosis (P <0.01). The circulating DNA of 51.2 ± 17.9ng / ml for PHC without lymph node metastasis and 73.9 ± 23.7ng / ml for circulating lymph node metastasis (P <0.05), but there was no significant difference in HBV-DNA load with or without lymph node metastasis . Conclusion: Combined detection of blood DNA and HBV DNA load predicts PHC, the prognostic value is obvious, and the method is simple and easy to carry out.