Clinical values of combined hepatoma-specific α-fetoprotein (AFP) fraction and AFP-mRNA determination in diagnosis and differentiation of hepatocellular carcinoma

Objective To explore the diagnostic values of hepatoma-specific alpha- fetoprotein fraction (AFP-L3) and circulating AFP-mRNA in patients with hepatocellular carcinoma (HCC).Methods Total RNAs were extracted from circulating blood, synthesized to cDNA through random primers and reverse transcriptase, the gene fragments of AFP were amplified by a nested-polymerase chain reaction (nested-PCR) assay. AFP-L3 was separated by lectin-affinity chromatography and both of AFP and AFP-L3 were detected by radio- immunoassay (RIA).Results Of HCC and cirrhosis group, the incidences of AFP-L3 were 91.7% and 18%, and AFP-mRNA were 56.7% and 16%, respectively, and neither was found in the control group. The incidence of AFP-L3 or AFP-mRNA in HCC group was significantly higher (P0.01) than that in liver cirrhosis group or control group. No significant relationship was found between AFP-L3% or AFP-mRNA and tumor size or numbers, except for HCC differentiation, metastasis and relapse (P0.05). Conclusion The analysis of AFP-L3 or AFP-mRNA fragment has better sensitivity, specificity, and both are useful markers to diagnose HCC or monitor metastasis and relapse.