Quantification of plasma hTERT DNA in hepatocellular carcinoma patients by quantitative fluorescent polymerase chain reaction.

PURPOSE: To investigate the levels of human telomerase reverse transcriptase (hTERT) DNA in the plasma of patients with hepatocellular carcinoma (HCC), and to evaluate the diagnostic value and correlation of hTERT DNA with clinical parameters in HCC. METHODS: A real-time quantitative fluorescent polymerase chain reaction (FQ-PCR) system was designed and evaluated. Plasma samples were collected from 60 HCC patients, 21 patients with hepatitis B virus (HBV) and 29 healthy controls. Plasma DNA was extracted and quantified by FQ-PCR. The diagnostic value of plasma hTERT DNA levels and their relationships with clinical characteristics were analyzed statistically. RESULTS: Plasma levels of hTERT DNA in HCC patients were significantly higher than in HBV patients (4.18×104±4.94×104 copies/µl vs 1.21×104±6.63×103 copies/µl, P=0.003) and healthy controls (4.18×104±4.94×104 copies/µl vs 1.44×104±6.61×103 copies/µl, P < 0.001). Receiver operating characteristic curve analysis indicated a sensitivity of 64% and a specificity of 90% for the ability of hTERT DNA levels to detect malignancy at a cutoff value of 1.87×104 copies/µl. Association analysis revealed that plasma hTERT DNA levels were closely related to tumor size, portal vein cancer embolus and TNM stage (P=0.013, P=0.010, and P=0.029, respectively), but were not associated with lymph node metastasis, hepatitis B surface antigen, or α-fetoprotein (AFP) (all P > 0.05). The levels of plasma hTERT DNA in HCC patients with AFP ≤20 ng/ml were significantly higher than in HBV patients (4.59×104±4.98×104 copies/µl vs 1.44×104±6.63×103 copies/µl, P=0.016) and in healthy controls (4.59×104±4.98×104 copies/µl vs 1.21×104±6.63×103 copies/µl, P=0.001). CONCLUSIONS: Quantitation of plasma hTERT DNA by FQ-PCR may provide a novel complementary tool with potential clinical applications for the screening and detection of HCC. Plasma hTERT DNA has the potential to be a broad tumor marker for common cancers.

Clinical significance of serum transforming growth factor-ß1 in lung cancer.

BACKGROUND: Transforming growth factor-ß1 (TGF-ß1) plays a critical role in human cancer development. Present study aimed to explore the clinical significance of serum TGF-ß1 levels in patients with lung cancer and analyze the relationship between TGF-ß1 and existing tumor markers for lung cancer. METHODS: Serum was collected from 118 patients with lung cancer and 40 healthy volunteers. Serum TGF-ß1 levels were measured by enzyme-linked immunosorbent assay (ELISA), and the association with various clinical characteristics was analyzed. The diagnostic value of TGF-ß1 was assessed alone and in combination with existing tumor markers for lung cancer. RESULTS: Serum TGF-ß1 levels were significantly higher in patients with lung cancer compared to healthy volunteers [0.6 × 10(5) (0.4 × 10(5), 0.9 × 10(5))pg/ml vs 0.5 × 10(5) (0.3 × 10(5), 0.7 × 10(5))pg/ml, P=0.040]. Although there was a positive correlation between serum TGF-ß1 levels and advanced stages, the significant difference was not found between early stages and advanced stages (P=0.116). The ability of serum TGF-ß1 to discriminate lung cancer at a cutoff value of 79,168 pg/ml exhibited sensitivity of 30.6% and specificity of 97.5%. Serum TGF-ß1 levels were correlated to cytokeratin fragment 21-1 (CYFRA21-1; R=0.308, P=0.020) and neuron-specific enolase (NSE; R=0.558, P=0.003). The diagnostic accuracy rates for the existing lung-tumor markers, as SCC, CYFRA21-1, and NSE, were increased from 20.0%, 34.6%, and 45.9% to 48.9%, 51.7%, and 54.5%, respectively by the inclusion of serum TGF-ß1 levels. CONCLUSION: Quantification of serum TGF-ß1 levels by ELISA may provide a novel complementary tool for the clinical diagnosis of lung cancer.