CAJ | 학술논문

目的：定量检测肝细胞癌（HCC）患者血浆循环 DNA（cf-DNA）含量，探讨其在原发性肝癌早期诊断及病情监测中的临床应用价值。方法收集40例肝细胞癌、30例代偿期肝硬化、20例活动性肝炎和25例正常健康对照血浆，提取血浆循环 DNA，采用 real-time 实时荧光定量 PCR 方法检测β-actin 基因的表达，确定血浆循环 DNA 的水平。结果 HCC 组、肝硬化组、肝炎组和健康对照组中位血浆循环 DNA 浓度分别为17．090 ng／ml、8．182 ng／ml、7．447 ng／ml 和9．014 ng／ml，HCC 组和健康对照组循环 DNA 水平比较有显著性差异（P ＜0．05）；肝硬化组、肝炎组和健康对照组比较无显著性差异（P ＞0．05），ROC 曲线分析表明血浆循环 DNA 水平能够区分肝癌和健康人（AUC＝0.8450），以循环 DNA 水平11．92 ng／ml 作为诊断 HCC 的临界值，其诊断的特异度是84．0％，敏感度是72．5％。血浆 cf-DNA 浓度与 AFP 联合检测可以将 HCC 诊断率提高至77．5％。结论 real time PCR 技术可精确定量血浆循环 DNA 浓度，检测血浆中循环 DNA 含量可作为诊断和监测原发性肝癌指标的有效补充。
목적：정량검측간세포암（HCC）환자혈장순배 DNA（cf-DNA）함량，탐토기재원발성간암조기진단급병정감측중적림상응용개치。방법수집40례간세포암、30례대상기간경화、20례활동성간염화25례정상건강대조혈장，제취혈장순배 DNA，채용 real-time 실시형광정량 PCR 방법검측β-actin 기인적표체，학정혈장순배 DNA 적수평。결과 HCC 조、간경화조、간염조화건강대조조중위혈장순배 DNA 농도분별위17．090 ng／ml、8．182 ng／ml、7．447 ng／ml 화9．014 ng／ml，HCC 조화건강대조조순배 DNA 수평비교유현저성차이（P ＜0．05）；간경화조、간염조화건강대조조비교무현저성차이（P ＞0．05），ROC 곡선분석표명혈장순배 DNA 수평능구구분간암화건강인（AUC＝0.8450），이순배 DNA 수평11．92 ng／ml 작위진단 HCC 적림계치，기진단적특이도시84．0％，민감도시72．5％。혈장 cf-DNA 농도여 AFP 연합검측가이장 HCC 진단솔제고지77．5％。결론 real time PCR 기술가정학정량혈장순배 DNA 농도，검측혈장중순배 DNA 함량가작위진단화감측원발성간암지표적유효보충。
Objective To quantify the circulating DNA level in plasma from patients with hepatocellular carcinoma (HCC),and to explore its significance for early diagnosis in HCC patients.Methods Blood samples were collected from 40 HCC patients,30 patients with liver cirrhosis,20 patients with chronic active hepatitis and 25 healthy controls. Circulating DNA in plasma was extracted and quantified by detecting the β-actin gene through real-time quantitative PCR method .Results The median values of plasma circulating DNA concentration among the HCC group,cirrhosis group ,hepatitis group and healthy control group were 17.090 ng/ml,8.182 ng/ml,7.447 ng/ml and 9.014 ng/ml re-spectively.There is significant difference between the HCC group and healthy control(P < 0.05)and no significant difference between the cirrhosis group and healthy control(P >0.05),no significant difference between the hepatitis group and healthy control(P >0.05).Receiver operating characteristic (ROC)analysis demonstrated that the circulat-ing DNA level could be used to distinguish HCC from healthy control (AUC=0.8450)with sensitivity of 72.5% and specificity of 84.0% at the cut-off value of 11.92 ng/ml.The combined analysis of using both plasma circulating DNA level and AFP revealed an elevated detection rate of 77.5%.Conclusion The detection of plasma circulating DNA level can be an effective supplement index for the diagnosis of HCC.