Detection of AFP-mRNA in Peripheral Blood of Patients with Hepatocellular Carcinoma and its Significance

Objective: The current study was designed to search into the detection of micrometastasis in peripheral blood in the patients with hepatocellular carcinoma(HCC) and its significance. Method: Peripheral blood samples were obtained from 65 patients with hepatocellular carcinoma, 21 non-HCC malignant tumors, 22 chronic hepatitis B or cirrhosis, and 21 cases of normal healthy volunteers. For identifying hepatocellular carcinoma cells in peripheral blood, the authors detected liver-specific alpha-fetoprotein (AFP) mRNA from total RNA extracted from whole blood by nested reverse transcription-polymerase chain reaction (Nested-RT-PCR). Results: AFP-mRNA was not detected in the normal healthy volunteers and the patient with non-HCC malignant tumors. The presence of AFP-mRNA in the patients with HCC (67. 7%, 44/65) was higher than those with chronic hepatitis B or cirrhosis (9.1%, 2/22, P0.01). The detective rate of AFP-mRNA in the blood seemed to be correlated with the clinical stages of HCC, the presence of extrahepatic metastasis, and portal vein thrombosis. The positive AFP-mRNA in peripheral blood after treatment was correlated with the prognosis of the patients with HCC. AFP-mRNA was detected in 7 of 12 (58. 3% ) HCC patients with low level of serum AFP (25μg/L). Conclusions: The presence of AFP-mRNA in peripheral blood may be an indicator of malignant or benign hepatocytes, which might predicate hematogenous spreading metastasis of tumor cells in the patients with HCC, it might be a valuable marker for predicting metastasis and recurrence of HCC, and it might play a supplementary role in the diagnosis of HCC with negative or low level of serum AFP.