title: Non-specificity of messenger RNA of alpha-fetoprotein in peripheral blood in detecting early spread of hepatocellular carcinoma in black Africans.
abstract: Awareness of early spread of hepatocellular carcinoma is crucial in selecting patients for surgical intervention. Alpha-fetoprotein is widely used as a serum marker for hepatocellular carcinoma. Our aim was to evaluate the specificity of alpha-fetoprotein-mRNA transcription in cells in the peripheral blood for diagnosing early spread of hepatocellular carcinoma in black Africans. Alpha-fetoprotein-, albumin- and prothrombin-mRNA were detected in peripheral blood mononuclear cells by reverse transcription-polymerase chain reaction. Alpha-fetoprotein-mRNA was shown in peripheral blood mononuclear cells in 53% (35/66) of patients with hepatocellular carcinoma, but also in 45% (10/22) of healthy blacks, 64% (14/22) of black patients with acute hepatitis, 55% (11/20) of those with chronic hepatitis or cirrhosis and 75% (9/12) of those with hepatic metastases (from a number of primary sites). Specificity of albumin- and prothrombin-mRNA was better than that of alpha-fetoprotein-mRNA, although the sensitivity was reduced. The corresponding prevalence of albumin-mRNA for each group of patients or controls was 30% (20/66), 9% (2/22), 41% (9/22), 10% (2/20), and 17% (2/12), respectively, and for prothrombin-mRNA 27% (18/66), 4.5% (1/22), 27% (6/22), 20% (4/20) and 17% (2/12), respectively. We conclude that the non-specificity of alpha-fetoprotein-mRNA transcription in peripheral blood in recognizing malignant hepatocytes in the circulation severely limits its usefulness in diagnosing the early spread of hepatocellular carcinoma in black Africans.
authors.affiliation: Department of Medicine, University of the Witwatersrand, Johannesburg, South Africa.
authors.forename: M A
authors.initials: MA
authors.lastname: Kedda
authors.forename: M C
authors.initials: MC
authors.lastname: Kew
authors.forename: M
authors.initials: M
authors.lastname: Skelton
authors.forename: J
authors.initials: J
authors.lastname: Hodkinson
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D044383:Black People / Q000235:genetics*; D006528:Carcinoma, Hepatocellular / Q000097:blood* / Q000208:ethnology / Q000556:secondary; D005260:Female; D006505:Hepatitis / Q000097:blood; D006801:Humans; D008103:Liver Cirrhosis / Q000097:blood; D008113:Liver Neoplasms / Q000097:blood* / Q000208:ethnology / Q000556:secondary; D008297:Male; D008875:Middle Aged; D012333:RNA, Messenger / Q000097:blood*; D014407:Tumor Cells, Cultured; D000509:alpha-Fetoproteins / Q000235:genetics*
chemical_list: D012333:RNA, Messenger; D000509:alpha-Fetoproteins