Detection of AFPmRNA and melanoma antigen gene-1mRNA as markers of disseminated hepatocellular carcinoma cells in blood.

BACKGROUND

The highly sensitive technique of reverse transcriptase-polymerase chain reaction(RT-PCR) has been used to detect circulating tumor cells. This study was undertaken to detect circulating hepatocellular carcinoma cells and to evaluate their potential clinical implication in HCC patients.

METHODS

Subjects included 65 patients with primary HCC, 22 patients with hepatitis B and liver cirrhosis, 12 patients with metastatic liver cancer, 11 patients with hepatic hemangioma, and 20 healthy volunteers. AFPmRNA and melanoma antigen gene (MAGE-1) mRNA in peripheral blood samples were tested using nested RT-PCR.

RESULTS

The positive rates of MAGE-1mRNA and AFPmRNA were 41.5% (27) and 53.8%(35), respectively in the HCC patients. In 64.6%(42) of the 65 patients, there was at least one positive marker. The positive rate of AFPmRNA or MAGE-1mRNA was correlated with portal thrombosis, nodules of tumor, tumor diameter and TNM stage (P<0.05). Samples from 4 (33.3%) of the 12 patients with metastatic liver cancer were MAGE-1mRNA positive, samples from 3(13.6%) of the 22 patients with cirrhosis AFPmRNA positive, and the others were both negative.

CONCLUSIONS

Nested RT-PCR is a sensitive and reliable method for detecting circulating HCC cells. A two-marker RT-PCR assay with a liver-specific AFP marker and a cancer specific MAGE-1 marker may be a promising tool for detecting blood disseminated HCC cells with a better sensitivity and specificity than a single marker RT-PCR.