Influence of surgical resection of hepatocellular carcinoma(HCC) for hematogenous dissemination of HCC cells and its effect on recurrence and metastasis: 3 years prospective study.

Aims was to study whether hepatal surgery leads to hematogenous dissemination of hepatocellular carcinoma (HCC) cells and determine period of its persistence by nested reverse transcription-polymerase chain reaction (RT-PCR). Peripheral vein blood (5ml) samples were obtained from 54 HCC patients of T1N0M0 and 6 HCC patients of T2N0M0 stage and 20 patients with liver cavernous hemangioma(LCH) before operation and 48h,72h and 1 week after surgical resection of hepatoma between Janurary 1st, 2007 and December 31th, 2010. We detected alpha-fetoprotein (AFP) messenger RNA(mRNA) by nested RT-PCR perioperatively.FPmRNA of all 60 cases of HCC patients and 20 cases of LCH were negative before hepatal surgery, 28 of 60 HCC cases became positve at 48h after surgery (46.7%), 16 of 60 HCC cases remained positive at 72h postoperatively(26.7%), none of 60 HCC patients AFPmRNA was detected at 1 week after hepatal surgery(0.0%). None of LCH patients were detected AFPmRNA after hepatal surgery(0.0%). For 28 HCC patients with AFPmRNA positive after hepatal surgery, 4 HCC patients developed intrahepatic tumor recurrences in 1st year (4/28, 14.3%),6 HCC patients relapsed in the second year(6/28,21.4%),10 HCC patients relapsed in the third year(10/28,35.7%). For 32 HCC patients with AFPmRNA negative group postoperation, 5 cases relapsed in 1st year (5/32, 15.6%),7 cases developed intrahepatic tumor recurrences in the second year (7/32, 21.9%),11 cases relasped in the third year (11/32, 34.4%,P>0.05),none of HCC patients occured distal metastasis after surgical resection of hepatoma. None of LCH patients relapsed postoperation within three years.Hepatal surgery may cause HCC cells spreading into peripheral blood shortly, but it may be not concerning with recurrence or metastasis of HCC.