[Influence of microwave ablation and surgical resection of small primary hepatocellular carcinoma on hematogenous dissemination of tumor cells].
OBJECTIVE
To study the influence of percutaneous microwave ablation (PMA) and surgical resection for patients with small primary hepatocellular carcinoma (PHC) on dissemination of tumor cells in peripheral blood determined by AFP mRNA.


METHODS
Forty patients with small PHC (The maximal diameter < or = 5 cm) confirmed histologically were included in this study. All the patients had single tumor nodule only without metastasis. Of the 40 patients, 19 were treated by PMA and 21 by surgical resection. Blood samples were collected and tested immediately before treatment, 30 min after the mass ablated/resected, 1 d and 7 d later by RTD-Nested-RT-PCR for AFP mRNA. The CD3, CD4, CD8 and CD4/CD8 in blood, and hepatic function were tested at the same time points as well.


RESULTS
After treatment, ALT and AST in peripheral blood increased in both groups, but more intensely in the surgical group. The CD3, CD4 and CD4/CD8 in peripheral blood decreased at 30 min, 1 day and 7 days after surgical resection, and the lowest value was at 30 min after surgery. The immune function was kept at the same level as pre-treatment in the PMA group. AFP mRNA copies in blood could be detected in 27 of 40 patients (67.5%) in two groups before treatment, and the copy number was increased after treatment. There was no significant difference between the two groups. The patients were followed up for 1 - 16 months. AFP mRNA copies in blood could be detected persistently in the 4 patients with extrahepatic metastasis or liver recurrence.


CONCLUSIONS
Surgical resection and microwave ablation may cause PHC cells dissemination into the blood circulation in patients with small PHC, and there was no difference between the two treatment groups. The cellular immune function in peripheral blood is decreased after surgical resection, but is maintained at the same level as pre-treatment in the PMA group. The impairment of liver function is less severe after PMA treatment than surgical resection. PMA may provide certain value for clinical management of small hepatocellular carcinoma.
Dong
Bao-wei
BW
Department of Ultrasonography, General Hospital of PLA, Beijing 100853, China.
Wen
Chao-yang
CY
Liang
Ping
P
Yu
Xiao-ling
XL
Su
Li
L
Yu
De-jiang
DJ
Xia
Hong-tian
HT
D000328:Adult; D000368:Aged; D017252:CD3 Complex / Q000097:blood; D015704:CD4 Antigens / Q000097:blood; D016516:CD4-CD8 Ratio; D016827:CD8 Antigens / Q000097:blood; D006528:Carcinoma, Hepatocellular / Q000097:blood / Q000601:surgery / Q000628:therapy*; D017115:Catheter Ablation / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006498:Hepatectomy; D006801:Humans; D008113:Liver Neoplasms / Q000097:blood / Q000601:surgery / Q000628:therapy*; D008297:Male; D008872:Microwaves / Q000627:therapeutic use*; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D012333:RNA, Messenger / Q000096:biosynthesis / Q000235:genetics; D000509:alpha-Fetoproteins / Q000096:biosynthesis* / Q000235:genetics
D017252:CD3 Complex; D015704:CD4 Antigens; D016827:CD8 Antigens; D012333:RNA, Messenger; D000509:alpha-Fetoproteins