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目的:探讨原发性肝癌(HCC)经皮肝穿刺细针活检端粒酶活性检测的临床意义。方法:25例直径1.2～3cm的HCC进行了无水酒精注射治疗(PEIT)。PEIT治疗前及PEIT治疗后1周在B超引导下经皮肝穿刺细针活检,所得微量肝癌组织采用非放射性同位素银染端粒重复序列扩增法(TRAP)行端粒酶活性检测及病理学检查。3例正常肝脏组织及5例肝硬变组织作为对照研究。结果:PEIT治疗前,病理学检查诊断率为80%(20/25),端粒酶活性阳性率为84%(21/25);PEIT治疗后1周,病理学检查未发现肿瘤细胞,3例端粒酶活性阳性(12%),其中1例经手术治疗后临床治愈,2例未手术治疗者1年内复发。其余22例端粒酶转阴的患者1年内未复发。3例正常肝脏组织及5例肝硬变组织端粒酶活性检测均阴性。结论:经皮肝穿刺活检微量肝脏组织端粒酶活性检测可应用于小肝癌的辅助诊断,在原发性肝癌PEIT治疗的疗效评价及预后判断方面具有一定的应用价值。
Objective: To investigate the clinical significance of telomerase activity in percutaneous transhepatic needle aspiration needle biopsy of primary liver cancer (HCC). METHODS: Twenty-five patients with HCC of 1.2-3 cm in diameter were treated with anhydrous alcohol injection (PEIT). Percutaneous transhepatic needle aspiration biopsy before PEIT and one week after PEIT were performed. The results showed that telomerase activity was detected by non-radioactive isotope silver-labeled telomeric repeat amplification (TRAP) Physical examination. 3 cases of normal liver tissue and 5 cases of cirrhosis as a control study. Results: The positive rate of pathological examination before PEIT was 80% (20/25) and the positive rate of telomerase activity was 84% (21/25). One week after PEIT, no tumor cells were found in the pathological examination, 3 Cases of positive telomerase activity (12%), of which 1 case was cured after surgery, 2 cases of non-surgical recurrence within 1 year. The remaining 22 cases of telomerase negative patients did not relapse within 1 year. Three cases of normal liver tissue and five cases of liver cirrhosis tissue telomerase activity were negative. CONCLUSION: The detection of telomerase activity in percutaneous liver biopsy can be applied in the diagnosis of small hepatocellular carcinoma. It has a certain value in evaluating the curative effect and prognosis of PEIT.