Correlative Study On The Relationship Between Two Therapeutical Strategies Of Primary Hepatocarcinoma And Hematogenous Dissemination Of HCC Cell

Background: the prognosis for patients with hepatocellular carcinoma often depends on tumor recurrence and the development of extrahepatic metastases.Recently, various methods of ablation using nonsurgical methods have been developed, with different degrees of success reported. Effective local ablation for small HCC can be potentially curative, as shown by the use of surgical resection .Therefore , surgical resection , microwave coagulation therapy(MCT) are widely used for small HCC and become important therapeutics. Although these treatment advances have improved the quality of life for patients with HCC, intra- and extrahepatic recurrence are still frequently observed after the therapeutics, and the prognosis for HCC is still far from satisfactory.Objective: to compare treatment results of surgical resection(SR) and microwave coagulation therapy(MCT) concerning micrometastasis and evaluate their effects on micrometastasis by means of detecting disseminated peripheral blood liver cancer cell using a multimarker nested RT-PCR assay with cancer-specific markers — MAGE-1 and MAGE-3 in combination with a liver-specific AFP marker after two primary therapeutics.Methods: we analyzed 5ml peripheral blood samples of 92 patients withhepatocellular carcinoma (TNM pStage II ) after two therapeutics—surgical resection and microwave coagulation therapy(MCT) and 10 benign hepatopathes after corresponding treatments using a multiple marker nested reverse transcriptase-polymerase chain reaction(RT-PCR) assay and investigated the changes of the expressions of three candidate gene markers respectively: AFP, MAGE-1 and MAGE-3. All enrolled patients expressed AFPmRNA , MAGE-lmRNA and MAGE-3mRNA negative before treatment. They were separated into SR group (tumor diameter ≤ 3cm 23cases; tumor diameter , 3cm 23cases)and MCT group(tumor diameter ≤ 3cm 23cases; tumor diameter , 3cm 23cases).Results: As to HCC tumor diameter≤3cm , after MCT only one case expressed AFPmRNA ,the positivity 4.35%(l/23) .In peripheral blood samples of other patients MAGE-lmRNA and/or MAGE-3mRNA were negative ; After SR the positive rate of AFPmRNA. MAGE-lmRNA and MAGE-3mRNA was 17.3% (4/23) , 8.70% (2/23) and 4.35% (1/23), respectively. The positivity for at least one gene transcript was 30.43% (7/23) .The positive rate of at least one gene transcript of SR group showed significantly higher than that of MCT group(P < 0.05) . As concerning HCC tumor diameter , 3cm , after MCT AFPmRNAs MAGE-lmRNA and MAGE-3mRNA were positive in 8.7% (2/ 23). 13.0% (3/23) and 4.35% (1/23) peripheral blood samples, respectively.21.7% (5/23) samples were detected to express at least one type of mRNA ; After SR AFPmRNA. MAGE-lmRNA and MAGE-3mRNA were...