Surgery Today

, Volume 35, Issue 12, pp 1033–1041

Association Between Recurrence of Hepatocellular Carcinoma and α-Fetoprotein Messenger RNA Levels in Peripheral Blood

Authors

  • Osakuni Morimoto
    • Department of Surgery and Clinical Oncology, Graduate School of MedicineOsaka University
  • Hiroaki Nagano
    • Department of Surgery and Clinical Oncology, Graduate School of MedicineOsaka University
  • Atsushi Miyamoto
    • Department of Surgery and Clinical Oncology, Graduate School of MedicineOsaka University
  • Yoshiyuki Fujiwara
    • Department of Surgery and Clinical Oncology, Graduate School of MedicineOsaka University
  • Motoi Kondo
    • Department of Surgery and Clinical Oncology, Graduate School of MedicineOsaka University
  • Tameyoshi Yamamoto
    • Department of Surgery and Clinical Oncology, Graduate School of MedicineOsaka University
  • Hideo Ota
    • Department of Surgery and Clinical Oncology, Graduate School of MedicineOsaka University
  • Masato Nakamura
    • Department of Surgery and Clinical Oncology, Graduate School of MedicineOsaka University
  • Hiroshi Wada
    • Department of Surgery and Clinical Oncology, Graduate School of MedicineOsaka University
  • Bazarragchaa Damdinsuren
    • Department of Surgery and Clinical Oncology, Graduate School of MedicineOsaka University
  • Shigeru Marubashi
    • Department of Surgery and Clinical Oncology, Graduate School of MedicineOsaka University
  • Keizo Dono
    • Department of Surgery and Clinical Oncology, Graduate School of MedicineOsaka University
  • Koji Umeshita
    • Department of Surgery and Clinical Oncology, Graduate School of MedicineOsaka University
  • Shoji Nakamori
    • Department of Surgery and Clinical Oncology, Graduate School of MedicineOsaka University
  • Masato Sakon
    • Department of Surgery and Clinical Oncology, Graduate School of MedicineOsaka University
  • Morito Monden
    • Department of Surgery and Clinical Oncology, Graduate School of MedicineOsaka University
Article

DOI: 10.1007/s00595-005-3077-5

Cite this article as:
Morimoto, O., Nagano, H., Miyamoto, A. et al. Surg Today (2005) 35: 1033. doi:10.1007/s00595-005-3077-5

Abstract

Purpose

Intra- and extrahepatic recurrence is common, even after curative resection for hepatocellular carcinoma (HCC), suggesting preoperative or intraoperative tumor cell dissemination. Reverse transcription — polymerase chain reaction (RT-PCR) for α-fetoprotein (AFP) is used to detect circulating liver cancer cells. We previously developed a quantitative method that allows estimation of the AFP mRNA level by real-time PCR. In the present study, we used this method to measure the AFP mRNA level before and after resection of HCC, then correlated the findings with various clinicopathological characteristics and prognosis.

Methods

We prospectively examined peripheral blood samples from 38 patients with HCC, and bone marrow aspirate from 25 of these patients. As a control, we examined bone marrow from 20 patients with benign diseases. The follow-up period ranged from 32 to 66 months. Real-time RT-PCR was used to detect AFP mRNA levels in the samples.

Results

AFP was expressed in 9 (23.7%) of the 38 peripheral blood samples. The detection of AFP mRNA was significantly correlated with extrahepatic metastasis after primary surgery, and a shorter disease-free survival time (P = 0.0245 each). Bone marrow samples were defined as positive if they expressed AFP mRNA at levels higher than the maximum expressed level in the controls, because only 1 (5%) of the 20 control bone marrow samples had low AFP mRNA expression. Using this cutoff level, 12 (48%) of the 25 patients with HCC had positivity for AFP mRNA. The results of bone marrow RT-PCR did not correlate with the clinocopathological characteristics of prognosis.

Conclusions

Using real-time PCR to measure the AFP mRNA level in blood, but not bone marrow, could be useful for predicting postoperative tumor recurrence.

Key words

Hepatocellular carcinomaMicrometastasisα-Fetoprotein messenger RNAMetastatic recurrence

Copyright information

© Springer-Verlag Tokyo 2005