Detection Of AFPmRNA And GPC3mRNA In Peripheral Blood Of Patients With Hepatocellular Carcinoma During Perioperative Period And Its Clinical Significance

ObjectiveSurgical resection and liver transplantation are the main methods of the treatment for hepatocellular carcinoma patients. Postoperative tumor recurrence, which develops in about 70% patients, must reflect the presence of microscopic extrahepatic disease (micrometastases) that has escaped detection by conventional preoperative imaging. In the presence of immunosuppression, these micrometastases may develop into clinically significant recurrence. Thus, the detection of the peripheral blood HCC is important not only for the judgement of the recurrence but also for the direction of clinic therapy. During these years, the highly sensitive technique of reverse-transcriptase (RT) polymerase chain reaction has been applied to the detection of micrometastases in blood from patients with malignant solid tumors. alpha-fetoprotein(AFP) gene transcripts have been employed as targets of the RT-PCR assay in blood from HCC patients. However, it is controversial whether the detection of these gene transcripts truly reflects the presence of tumor cells, since the sensitivity is 39%-64% and the specificity is 76%-91%,and non-HCC(normal liver cells,heptatitis cells, hepatocirrhosis cells)also excrete AFP messenger RNA(mRNA)s. Additionally, the metastatic tumors may be different from the primary tumors in the gene expression since tumors are heterogeneous in gene expression. Therefore, single marker assay may lead to false negative results. GPC3 is a highly specific gene of hepatocarcinoma found in recent years. The expression rate of hepatocarcinoma is remarkably increasing, and no expression is found in non-carcinoma and para-carcinoma tissues. It is then possible that GPC3 would be a new ideal molecular marker of hepatocarcinoma. For the above-mentiond problems, we presume that GPC3 incombination with AFP will improve the sensitivity and specificity of detecting the micrometastases.We examined the expression of AFPmRNA and GPC3mRNA by RT-PCR in peripheral vein blood specimens obtained from patients with HCC. The purpose was to assess the...