[AFP mRNA expression in peripheral blood correlates with metastasis of hepatocellular carcinoma]

To investigate the status of hematogenous spread of hepatocellular carcinoma (HCC) and the significance of peripheral blood AFP mRNA expression as a predictive marker for metastasis of HCC.

Peripheral blood samples were collected from 54 patients with HCC, 20 of whom had received interventional therapy before samples were collected, and from 30 subjects as control(10 cases with benign liver disease, 20 healthy donors). AFP cDNA was amplified from total RNA extracted from 5 ml whole blood by nested reverse transcription polymerase chain reaction(RT-PCR).

Of the 54 HCC patients, 26(48.1%) patients had positive AFP mRNA, while AFP mRNA was detected in only 1 of the 10 patients with benign liver disorder and 1 of the 20 healthy subjects. In 16 HCC patients with intra- and extra-hepatic metastases, 13 (81.3%) were positive for AFP mRNA. In patients who did not yet have metastasis, 34.2% of them (13/38) gave positive AFP mRNA. The presence of AFP mRNA correlated with the stage of HCC and the presence of intrahepatic and/or extrahepatic metastasis, but did not correlate with the tumor size and the serum AFP level. There was no significant difference in AFP mRNA expression before and after surgical treatment or transcatheter arterial chemoembolization.

AFP mRNA is a valuable marker for detecting hematogenous dissemination and metastasis of HCC. Systemic chemotherapy or immunotherapy is needed to prevent clinically overt metastasis and recurrence.