• 1. 安徽醫(yī)科大學(xué)第一附屬醫(yī)院器官移植中心(安徽合肥 230022);;
  • 2. 香港中文大學(xué)威爾斯親王醫(yī)院病理解剖及細(xì)胞學(xué)系(中國(guó)香港);

目的  評(píng)估外周血漿DNA甲基化檢測(cè)在肝細(xì)胞肝癌(HCC)診斷中的作用,篩選血漿靈敏度及特異性高的甲基化抑癌基因。
方法  采用甲基化特異性PCR (MSP)檢測(cè)34例經(jīng)病理檢查證實(shí)的HCC患者血漿及其配對(duì)癌組織中的SLIT2及DAPK基因啟動(dòng)子甲基化狀態(tài),并分析其與HCC臨床病理特征的關(guān)系。
結(jié)果  34例HCC患者癌組織中SLIT2和DAPK基因甲基化率分別為70.6% (24/34)和79.4%(27/34),相應(yīng)外周血漿中SLIT2和DAPK基因甲基化率分別為44.1%?(15/34)和50.0% (17/34)。血漿SLIT2和DAPK基因甲基化檢測(cè)的靈敏度分別為62.5%和63.0%,特異度均為100%,陰性預(yù)測(cè)值分別為52.6%和41.2%,陽(yáng)性預(yù)測(cè)值均為100%。HCC癌組織和外周血漿中SLIT2及DAPK甲基化檢出率與HCC各臨床病理特征無(wú)關(guān)(P>0.05)。在AFP<400μg/L患者中SLIT2和DAPK基因甲基化聯(lián)合檢出率達(dá)61.1% (11/18)。
結(jié)論  基于MSP方法,血漿中SLIT2及DAPK基因甲基化仍有較高的檢出率,HCC癌組織和血漿中SLIT2及DAPK基因甲基化具有明顯的一致性。 血漿DNA甲基化可作為一種獨(dú)立非侵入性診斷HCC的標(biāo)志物,尤其對(duì)AFP陰性者可提高HCC的診斷率。 HBV感染可能僅與部分抑癌基因甲基化相關(guān)。

引用本文: 王平,耿小平,朱立新,李曉明,李棟. 肝細(xì)胞肝癌中外周血漿DNA 基因甲基化檢測(cè)及意義. 中國(guó)普外基礎(chǔ)與臨床雜志, 2012, 19(7): 727-732. doi: 復(fù)制

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2. Schlechte HH, Stelzer C, Weickmann S, et al. TP53 gene in blood plasma DNA of tumor patients [J]. Ann NY Acad Sci,2004, 1022(6):61-69.
3. Mandel P, Metais P. Les acides nucleiques du plasma sanguin chez l’homme [J]. CR Acad Sci Paris, 1948, 142:241-243.
4. Leon SA, Shapiro B, Sklarof DM, et a1. Free DNA in the serum of cancer patients and the efect of thempy [J]. Cancer Res,1977, 37(3): 646-650..
5. Vaart MVD, Pretorius PJ. Is the role of circulating DNA as a biomarker of cancer being prematurely overrated? [J]. Clinical Biochemistry, 2010, 43(1): 26-36.
6. 黃朝暉, 胡瑜, 華東, 等. 定量PCR 檢測(cè)肝細(xì)胞癌患者循環(huán)血漿DNA 及其臨床意義 [J]. 中國(guó)癌癥雜志, 2010, 20(9):663-667.
7. Jackson PE, Qian GS, Friesen MD, et al. Specific p53 mutations detection in plasma and tumors of hepatocellular carcinoma patients by electrospray ionization mass spectrometry [J]. Cancer Res, 2001, 61(1):33-35.
8. Chang YC, Ho CL, Chen HHW, et al. Molecular diagnosis of primary liver cancer by microsatellite DNA analysis in the serum [J]. Brit J Cancer, 2002, 87(12): 1449-1453.
9. Board RE, Williams VS, Knight L, et al. Isolation and extraction of circulating tumor DNA from patients with small cell lung cancer [J]. Ann NY Acad Sci, 2008, 1137(8): 98-107.
10. Chan KC, Yeung SW, Lui WB, et al. Effects of preanalytical factors on the molecular size of cell-free DNA in blood [J]. Clin Chem, 2005, 51(4):781-784.
11. Thierry AR, Mouliere F, Gongora C, et al. Origin and quantification of circulating DNA in mice with human colorectal cancer xenografts [J]. Nucleic Acids Res, 2010, 38(18): 6159-6175.
12. 張敬杰, 歐陽(yáng)濤, 萬(wàn)文徽, 等. 乳腺癌患者外周血漿中游離的腫瘤相關(guān)DNA 檢測(cè)及其臨床價(jià)值 [J]. 中華腫瘤雜志, 2007,29(8): 609-613.
13. Iyer P, Zekri AR, Hung CW, et al. Concordance of DNA methylation pattern in plasma and tumor DNA of Egyptian hepatocellular carcinoma patients [J]. Exp Mol Pathol, 2010, 88(1):107-111.
14. Wong IH, Lo YM, Zhang J , et al. Detection of aberrant p16 methylation in the plasma and serum of liver cancer patients [J].Cancer Res, 1999, 59(1): 71-73.
15. An Q, Liu Y, Gao Y, et al. Detection of p16 hypermethylation in circulating plasma DNA of non-small cell lung cancer patients [J]. Cance Lett, 2002, 188(1): 109-114.
16. Fujiwara K, Fujimoto N, Tabata M, et al. Identification of epigenetic aberrant promoter methylation in serum DNA is useful for early detection of lung cancer [J]. Clin Cancer Res, 2005,11(3): 1219-1225.
17. Chang H, Yi B, Li L, et al. Methylation of tumor associated genes in tissue and plasma samples from liver disease patients [J]. Exp Mol Pathol, 2008, 85(2): 96-100.
18. Leerapun A, Suravarapu SV, Bida JP, et al. The utility of lens culinaris agglutinin reactive alpha-fetoprotein in the diagnosis of hepatocellular carcinoma:evaluation in a United States referral population [J]. Clin Gastroenterol Hepatol, 2007, 5(3): 394-402..
19. Nakagawa T, Seki T, Shiro T, et al. Clinicopathologic significance of protein induced vitamin K absence or antagonist Ⅱ and alpha-fetoprotein in hepatocellular carcinoma [J]. Int J Oncol,1999, 14(2) : 281-286.
20. Nishida N, Nagasaka T, Nishimura T, et al. Aberrant methylation of multiple tumor suppressor genes in aging liver, chronic hepatitis, and hepatocellular carcinoma [J]. Hepatology,2008, 47(3): 908-918.
21. Shim YH, Yoon GS, Choi HJ, et al. p16 Hypermethylation in the early stage of hepatitis B virus associatedhepatocarcinogenesis [J]. Cancer Lett, 2003, 190(2): 213-219.
  1. 1. Gautschi O, Bigosch C, Huegli B, et al. Circulating deoxyribonucleic acid as prognostic mark in non-small-cell lung cancer patients undergoing chemotherapy [J]. J Clin Oncol, 2004,22(20):4157-4164.
  2. 2. Schlechte HH, Stelzer C, Weickmann S, et al. TP53 gene in blood plasma DNA of tumor patients [J]. Ann NY Acad Sci,2004, 1022(6):61-69.
  3. 3. Mandel P, Metais P. Les acides nucleiques du plasma sanguin chez l’homme [J]. CR Acad Sci Paris, 1948, 142:241-243.
  4. 4. Leon SA, Shapiro B, Sklarof DM, et a1. Free DNA in the serum of cancer patients and the efect of thempy [J]. Cancer Res,1977, 37(3): 646-650..
  5. 5. Vaart MVD, Pretorius PJ. Is the role of circulating DNA as a biomarker of cancer being prematurely overrated? [J]. Clinical Biochemistry, 2010, 43(1): 26-36.
  6. 6. 黃朝暉, 胡瑜, 華東, 等. 定量PCR 檢測(cè)肝細(xì)胞癌患者循環(huán)血漿DNA 及其臨床意義 [J]. 中國(guó)癌癥雜志, 2010, 20(9):663-667.
  7. 7. Jackson PE, Qian GS, Friesen MD, et al. Specific p53 mutations detection in plasma and tumors of hepatocellular carcinoma patients by electrospray ionization mass spectrometry [J]. Cancer Res, 2001, 61(1):33-35.
  8. 8. Chang YC, Ho CL, Chen HHW, et al. Molecular diagnosis of primary liver cancer by microsatellite DNA analysis in the serum [J]. Brit J Cancer, 2002, 87(12): 1449-1453.
  9. 9. Board RE, Williams VS, Knight L, et al. Isolation and extraction of circulating tumor DNA from patients with small cell lung cancer [J]. Ann NY Acad Sci, 2008, 1137(8): 98-107.
  10. 10. Chan KC, Yeung SW, Lui WB, et al. Effects of preanalytical factors on the molecular size of cell-free DNA in blood [J]. Clin Chem, 2005, 51(4):781-784.
  11. 11. Thierry AR, Mouliere F, Gongora C, et al. Origin and quantification of circulating DNA in mice with human colorectal cancer xenografts [J]. Nucleic Acids Res, 2010, 38(18): 6159-6175.
  12. 12. 張敬杰, 歐陽(yáng)濤, 萬(wàn)文徽, 等. 乳腺癌患者外周血漿中游離的腫瘤相關(guān)DNA 檢測(cè)及其臨床價(jià)值 [J]. 中華腫瘤雜志, 2007,29(8): 609-613.
  13. 13. Iyer P, Zekri AR, Hung CW, et al. Concordance of DNA methylation pattern in plasma and tumor DNA of Egyptian hepatocellular carcinoma patients [J]. Exp Mol Pathol, 2010, 88(1):107-111.
  14. 14. Wong IH, Lo YM, Zhang J , et al. Detection of aberrant p16 methylation in the plasma and serum of liver cancer patients [J].Cancer Res, 1999, 59(1): 71-73.
  15. 15. An Q, Liu Y, Gao Y, et al. Detection of p16 hypermethylation in circulating plasma DNA of non-small cell lung cancer patients [J]. Cance Lett, 2002, 188(1): 109-114.
  16. 16. Fujiwara K, Fujimoto N, Tabata M, et al. Identification of epigenetic aberrant promoter methylation in serum DNA is useful for early detection of lung cancer [J]. Clin Cancer Res, 2005,11(3): 1219-1225.
  17. 17. Chang H, Yi B, Li L, et al. Methylation of tumor associated genes in tissue and plasma samples from liver disease patients [J]. Exp Mol Pathol, 2008, 85(2): 96-100.
  18. 18. Leerapun A, Suravarapu SV, Bida JP, et al. The utility of lens culinaris agglutinin reactive alpha-fetoprotein in the diagnosis of hepatocellular carcinoma:evaluation in a United States referral population [J]. Clin Gastroenterol Hepatol, 2007, 5(3): 394-402..
  19. 19. Nakagawa T, Seki T, Shiro T, et al. Clinicopathologic significance of protein induced vitamin K absence or antagonist Ⅱ and alpha-fetoprotein in hepatocellular carcinoma [J]. Int J Oncol,1999, 14(2) : 281-286.
  20. 20. Nishida N, Nagasaka T, Nishimura T, et al. Aberrant methylation of multiple tumor suppressor genes in aging liver, chronic hepatitis, and hepatocellular carcinoma [J]. Hepatology,2008, 47(3): 908-918.
  21. 21. Shim YH, Yoon GS, Choi HJ, et al. p16 Hypermethylation in the early stage of hepatitis B virus associatedhepatocarcinogenesis [J]. Cancer Lett, 2003, 190(2): 213-219.