title: Is the expression of gamma-glutamyl transpeptidase messenger RNA an indicator of biological behavior in recurrent hepatocellular carcinoma?
abstract: OBJECTIVE
  To investigate the correlation between gamma-glutamyl transpeptidase (gamma-GTP) expression in the primary HCC and post-resection recurrence and its biological behaviors.
  
  
  METHODS
  Forty consecutive patients having curative resection for HCC were included in this study. The primers for reverse-transcription polymerase chain reaction (RT-PCR) were corresponding to the 5'-noncoding human gamma-GTP mRNA of fetal liver (type A), HepG2 cells (type B), and placenta (type C). Both the cancer and non-cancerous tissues of the resected liver were analyzed. The correlations between the expression of gamma-GTP and the clinicopathological variables and outcomes (recurrence and survival) were studied.
  
  
  RESULTS
  Those with type B gamma-GTP mRNA in cancer had significant higher recurrence rate than those without it (63.6 % vs 14.3 %). Both those with type B in cancer and in non-cancer died significantly more than those without it (45.5 % vs 0 % and 53.6 % vs 0 %, respectively). By multivariate analysis, the significant predictors of recurrence included high serum AFP (P=0.0108), vascular permeation (P=0.0084), and type B gamma-GTP mRNA in non-cancerous liver (P=0.0107). The significant predictors of post-recurrence death included high serum AFP (P=0.0141), vascular permeation (P=0.0130), and daughter nodules (P=0.0053). As to the manifestations (recurrent number >=2, recurrent extent >=2 segments, extra-hepatic metastasis, and death) in recurrent patients, there were no statistical significant differences between those with type B in the primary tumor and those without it. The difference between those with type B in non-cancerous liver and those without it also was not significant.
  
  
  CONCLUSIONS
  Patients of HCC with type B gamma-GTP mRNA both in cancer and in non-cancerous tissue had a worse outcome, earlier recurrence, and more post-recurrence death.
authors.affiliation: Liver Research Unit, Chang Gung Memorial Hospital, Taipei, Taiwan, China.
authors.forename: I-Shyan
authors.initials: IS
authors.lastname: Sheen
authors.forename: Kuo-Shyang
authors.initials: KS
authors.lastname: Jeng
authors.forename: Yi-Chun
authors.initials: YC
authors.lastname: Tsai
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000503:physiopathology* / Q000601:surgery*; D005260:Female; D006801:Humans; D007527:Isoenzymes / Q000235:genetics / Q000378:metabolism; D008113:Liver Neoplasms / Q000503:physiopathology* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000503:physiopathology*; D012333:RNA, Messenger / Q000378:metabolism; D005723:gamma-Glutamyltransferase / Q000235:genetics / Q000378:metabolism*
chemical_list: D007527:Isoenzymes; D012333:RNA, Messenger; D005723:gamma-Glutamyltransferase