title: Detection of AFP mRNA-expressing cells in the peripheral blood for prediction of HCC recurrence after living donor liver transplantation.
abstract: The aim of this study was to evaluate the hypothesis that the detection of alpha-fetoprotein (AFP) mRNA-expressing cells could be a novel, direct and accurate method for predicting tumor recurrence after living donor liver transplantation (LDLT) in patients with hepatocellular carcinoma (HCC). The test group consisted of 32 patients who underwent LDLT for end-stage liver disease with HCC. Quantitative real-time reverse transcription polymerase chain reaction was used for the detection of AFP mRNA-expressing cells in the peripheral blood. Nine (28.1%) of the 32 patients developed tumor recurrences during the follow-up period (mean, 27.9 months). The test for the presence of AFP mRNA in the peripheral blood was positive either preoperatively or postoperatively in 11 (34.3%) of the 32 patients, and positive preoperatively in three patients (9.4%). Univariate analysis revealed that a positive preoperative test for peripheral blood AFP mRNA, as well as exceeding Milan criteria and microscopic evidence of vascular invasion were significant predictors for the recurrence of HCC (P = 0.002, 0.049, and 0.001, respectively). Multivariate analysis using Cox's proportional hazards model revealed that a positive preoperative test for peripheral blood AFP mRNA was an independent risk factor for the recurrence of HCC. We concluded that the presence of AFP mRNA-expressing cells preoperatively could be a useful predictor of the recurrence of HCC in liver transplant patients.
authors.affiliation: Department of Surgery, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita City, Osaka, Japan.
authors.forename: Shigeru
authors.initials: S
authors.lastname: Marubashi
authors.forename: Keizo
authors.initials: K
authors.lastname: Dono
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Nagano
authors.forename: Yukari
authors.initials: Y
authors.lastname: Sugita
authors.forename: Tadafumi
authors.initials: T
authors.lastname: Asaoka
authors.forename: Naoki
authors.initials: N
authors.lastname: Hama
authors.forename: Atsushi
authors.initials: A
authors.lastname: Miyamoto
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Takeda
authors.forename: Koji
authors.initials: K
authors.lastname: Umeshita
authors.forename: Morito
authors.initials: M
authors.lastname: Monden
mesh_terms: D000328:Adult; D001773:Blood Cells / Q000378:metabolism*; D001808:Blood Vessels / Q000473:pathology; D006528:Carcinoma, Hepatocellular / Q000097:blood / Q000473:pathology / Q000601:surgery*; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000097:blood / Q000473:pathology / Q000601:surgery*; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009361:Neoplasm Invasiveness; D009364:Neoplasm Recurrence, Local; D011237:Predictive Value of Tests; D016016:Proportional Hazards Models; D012333:RNA, Messenger / Q000097:blood*; D012307:Risk Factors; D000509:alpha-Fetoproteins / Q000235:genetics*
chemical_list: D012333:RNA, Messenger; D000509:alpha-Fetoproteins