title: Real-time quantification of AFP mRNA to assess hematogenous dissemination after transarterial chemoembolization of hepatocellular carcinoma.
abstract: OBJECTIVE
  To determine whether the number of hepatocytes containing AFP mRNA shed into the bloodstream during transarterial chemoembolization (TAE) affects the incidence and pattern of recurrence of hepatocellular carcinoma (HCC).
  
  
  METHODS
  We developed a Taqman procedure to quantify AFP mRNA prospectively in 52 consecutive patients before and after TAE. Results are expressed in hepatocytes /mL.
  
  
  RESULTS
  Thirteen of the patients (24.5%) were positive for AFP mRNA (42 +/- 19 hepatocytes/mL) before TAE and 13 (24.5%) (80 +/- 32 hepatocytes/mL) after TAE; the difference was not significant. The presence of AFP mRNA in the bloodstream before TAE was associated with larger nodules (85.2 +/- 73.8 mm versus 34.8 +/- 26.1 mm; P = 0.006). Six of the patients were excluded from the analysis because they underwent curative surgery or were lost to follow-up. The circulating levels of AFP mRNA released in the 46 remaining patients after TAE did not affect metastasis-free survival. A significant number of extrahepatic metastases were found in patients exhibiting at least 1 AFP mRNA-positive blood sample either before or after TAE. However, the TAE procedure did not increase the risk of extrahepatic recurrences.
  
  
  CONCLUSIONS
  Cells containing AFP mRNA are inconsistently released into the circulation during TAE. The amount of these cells released does not affect the recurrence of HCC.
authors.affiliation: Service de Biochimie et Biologie Moléculaire-INSERM 268, France.
authors.forename: Marine
authors.initials: M
authors.lastname: Gross-Goupil
authors.forename: Raphaël
authors.initials: R
authors.lastname: Saffroy
authors.forename: Daniel
authors.initials: D
authors.lastname: Azoulay
authors.forename: Sophie
authors.initials: S
authors.lastname: Precetti
authors.forename: Jean-François
authors.initials: JF
authors.lastname: Emile
authors.forename: Valérie
authors.initials: V
authors.lastname: Delvart
authors.forename: Fréderic
authors.initials: F
authors.lastname: Tindilière
authors.forename: Alexis
authors.initials: A
authors.lastname: Laurent
authors.forename: Marie-France
authors.initials: MF
authors.lastname: Bellin
authors.forename: Henri
authors.initials: H
authors.lastname: Bismuth
authors.forename: Brigitte
authors.initials: B
authors.lastname: Debuire
authors.forename: Antoinette
authors.initials: A
authors.lastname: Lemoine
mesh_terms: D000328:Adult; D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000097:blood* / Q000556:secondary* / Q000628:therapy; D016461:Chemoembolization, Therapeutic / Q000009:adverse effects* / Q000379:methods; D003196:Computer Graphics; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000097:blood* / Q000473:pathology* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D009360:Neoplastic Cells, Circulating; D011446:Prospective Studies; D012333:RNA, Messenger / Q000097:blood*; D012680:Sensitivity and Specificity; D018709:Statistics, Nonparametric; D000509:alpha-Fetoproteins / Q000032:analysis*
chemical_list: D012333:RNA, Messenger; D000509:alpha-Fetoproteins