Postoperative detection of alpha-fetoprotein mRNA in blood as a predictor for metastatic recurrence of hepatocellular carcinoma.
BACKGROUND
We tested for the presence of alpha-fetoprotein (AFP) mRNA by using nested RT-PCR in the peripheral blood of hepatocellular carcinoma (HCC) patients who had undergone curative surgery, and investigated the occurrence of intrahepatic and/or extrahepatic metastasis thereafter, to reveal the optimal timing of blood sampling for the prediction of metastatic recurrence.


METHODS
Twenty-nine patients with HCC, who had been operated on were analyzed with RT-PCR at several points during the clinical course, and examined for metastatic recurrence for 3-28 months (mean = 18.7 months) after surgery.


RESULTS
The presence of AFP mRNA before surgery was significantly correlated with the tumor size (P = 0.017). Metastatic recurrence was associated with the postoperative detection of AFP mRNA (P < 0.001), but not with the preoperative and/or perioperative detection. Furthermore, AFP mRNA was detected in some cases that showed low serum AFP levels at recurrence. The recurrence-free period after the detection of AFP mRNA varied from 1 to 12 months.


CONCLUSIONS
The postoperative detection of AFP mRNA is useful for the prediction of metastatic recurrence, and long-term follow up with this method should be conducted.
Minata
M
M
Department of Medicine and Clinical Science, Kyoto University Graduate School of Medicine, Japan.
Nishida
N
N
Komeda
T
T
Azechi
H
H
Katsuma
H
H
Nishimura
T
T
Kuno
M
M
Ito
T
T
Yamamoto
Y
Y
Ikai
I
I
Yamaoka
Y
Y
Fukuda
Y
Y
Nakao
K
K
D000328:Adult; D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000097:blood / Q000556:secondary* / Q000601:surgery*; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000097:blood* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011184:Postoperative Period; D011379:Prognosis; D012333:RNA, Messenger / Q000097:blood*; D000509:alpha-Fetoproteins / Q000235:genetics*
D012333:RNA, Messenger; D000509:alpha-Fetoproteins