CAJ | 학술논문

背景: 自体干细胞移植治疗肝硬化在临床上已有诸多报道,但迄今为止,关于干细胞与移植后肝硬化的预后转归,干细胞在受损肝内定向分化及恶性学表型等一直是临床专家关注的热点.目的: 动态监测经门静脉外周血干细胞移植治疗失代偿期肝硬化患者的血清甲胎蛋白及甲胎蛋白异质体3变化,评估治疗方法的安全性.方法: 纳入2007-04来解放军总参谋部总医院行经门静脉外周血干细胞移植治疗的失代偿期肝硬化患者44例,以化学发光法检测患者术前及术后血清甲胎蛋白和甲胎蛋白异质体3水平的变化,以甲胎蛋白异质体3(%)≥10%作为阳性判断标准,分析干细胞移植治疗失代偿期肝硬化与肝癌恶性表型的关系.结果与结论: 干细胞移植2个月,患者血清甲胎蛋白出现一过性升高,移植前、后患者血清甲胎蛋白异质体3(%)水平差异无显著性意义(P>0.05),且不同甲胎蛋白浓度患者的甲胎蛋白异质体3阳性率及甲胎蛋白异质体3(%)差异无显著性意义(P>0.05).说明失代偿期肝硬化患者经外周血干细胞移植后临床症状及肝功能得到一定程度恢复.检测肝癌血清学标记物甲胎蛋白异质体3未提示在短期内有恶性生物学表型行为出现.
배경: 자체간세포이식치료간경화재림상상이유제다보도,단흘금위지,관우간세포여이식후간경화적예후전귀,간세포재수손간내정향분화급악성학표형등일직시림상전가관주적열점.목적: 동태감측경문정맥외주혈간세포이식치료실대상기간경화환자적혈청갑태단백급갑태단백이질체3변화,평고치료방법적안전성.방법: 납입2007-04래해방군총삼모부총의원행경문정맥외주혈간세포이식치료적실대상기간경화환자44례,이화학발광법검측환자술전급술후혈청갑태단백화갑태단백이질체3수평적변화,이갑태단백이질체3(%)≥10%작위양성판단표준,분석간세포이식치료실대상기간경화여간암악성표형적관계.결과여결론: 간세포이식2개월,환자혈청갑태단백출현일과성승고,이식전、후환자혈청갑태단백이질체3(%)수평차이무현저성의의(P>0.05),차불동갑태단백농도환자적갑태단백이질체3양성솔급갑태단백이질체3(%)차이무현저성의의(P>0.05).설명실대상기간경화환자경외주혈간세포이식후림상증상급간공능득도일정정도회복.검측간암혈청학표기물갑태단백이질체3미제시재단기내유악성생물학표형행위출현.
BACKGROUND:Transplantation of autologous stem cells for treatment of liver cirrhosis has been widely reported.But up to now,there exist some concerns for clinical physicians,including relationship between stem cells and post-transplantation prognosis/turnover of liver cirrhosis,directed differentiation of stem cells in the impaired liver,and malignant phenotype.OBJECTIVE:To dynamically monitor the serum levels of alpha-fetoprotein(AFP)and AFP variants(AFP-L3)in decompensated cirrhosis patients following intrahepatic transplantation of peripheral blood stem calls via portal vein and evaluate the safety of this treatment method.METHODS:A total of 44 decompensated cirrhosis patients who underwent intrahepatic transplantation of peripheral blood stem cells via portal vein in the 309 Hospital of Chinese PLA in April 2007 were included in this study.Prior to and after surgery,serum levels of AFP and AFP-L3 were detected by chemiluminescence.Through the use of a positive criterion for liver cirrhosis,i.e.,the proportion of AFP-L3 in AFP[AFP-L3(%)]≥10%,and the relationship between decompensated cirrhosis treatment using stem cells transplantation and the malignant phenotype of liver cancer were analyzed.RESULTS AND CONCLUSION:At 2 months after surgery,serum level of AFP showed a transient increase.There was no significant difference in AFP-L3(%)between prior to and after surgery(P>0.05).No significant difference in AFP-L3-positve rate,as well as AFP-L3(%),existed among patients with different serum level of AFP.These findings indicate that clinical symptoms and liver function of decompensated cirrhosis patients recovered to some extent after transplantation of peripheral blood stem cells via portal vein.Results regarding serum level of AFP-L3,a serological marker of liver cancer,did not demonstrate the appearance of malignant biological phenotype.