Clinical value of circulating peripheral blood mononuclear cell glypican-3 mRNA and alpha fetoprotein for diagnosing and monitoring metastasis of hepatocellular carcinoma

Objective To measure the circulating peripheral blood mononuclear cell(PBMC) expression of glypican-3(GPC-3) and levels of alpha fetoprotein(AFP) and assess their values for diagnosing and monitoring metastasis of hepatocellular carcinoma(HCC).Methods Total RNA was extracted from PBMCs of patients with HCC(n=55),liver cirrhosis(n=20),chronic hepatitis(n=20),metastatic HCC(n=20),non-liver tumors(n=20),and normal controls(n=20).GPC-3 gene expression was measured by fluorescence reverse transcription quantitative PCR.Intergroup differences were assessed by the Chi-squared test or Fisher's exact test.Results Positive expression of GPC-3 mRNA in PBMCs was only detected in HCC patients(70.9% vs.0 in all other groups;χ2=26.773,P0.001).Furthermore,the expression of GPC-3 mRNA in PBMCs was associated with HBV infection(χ2=14.601,P0.001),TNM stage(χ2=15.252,P0.001),periportal cancerous embolus(χ2=45.658,P0.001),and extrahepatic metastasis(χ2=22.273,P0.001).No relation was found between GPC-3 mRNA in PBMCs and size of tumors,number of tumors,AFP level,or tumor differentiation degree.The AFP-positive rate for HCC patients was 63.6%.The combination of GPC-3 up-regulated expression in PBMCs and enhanced serum AFP was found in 90.9% of HCC patients.Conclusion The GPC-3 mRNA level in circulating PBMCs and serum AFP level may be useful biomarkers for diagnosing HCC and its metastasis.