Kobayashi Shogo, Tomokuni Akira, Takahashi Hidenori, Akita Hirofumi, Sugimura Keijiro, Miyoshi Norikatsu, Moon Jeong Ho, Yasui Masayoshi, Omori Takeshi, Ohue Masayuki, Fujiwara Yoshiyuki, Yano Masahiko, Sakon Masato
Department of Surgery, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan.
Gastrointest Tumors. 2017 Mar;3(3-4):141-152. doi: 10.1159/000455955. Epub 2017 Feb 8.
BACKGROUND/AIMS: Alpha-fetoprotein (AFP) mRNA-expressing cells are candidates for circulating tumor cells in hepatocellular carcinoma. We analyzed portal vein blood, peripheral blood, and peritoneal lavage samples to detect the presence of AFP mRNA-expressing cells, and explored their relationship with metastasis.
We measured the AFP mRNA expression in 112 sets of portal vein and peripheral blood samples and 61 peritoneal lavage samples that had been obtained during surgery. We estimated the change in the positive ratio of patients with AFP mRNA, the associated background factors, and the rate of recurrence.
The change in AFP mRNA positivity in the peripheral blood specimens was remarkable, while that in the portal vein blood and peritoneal lavage samples was similar during hepatectomy. Tumor location was the only factor associated with AFP mRNA positivity. The rate of recurrence was higher in the patients who were positive for AFP mRNA than in those who were negative 9-24 months after hepatectomy. During this limited period, the recurrence rate in the AFP mRNA-positive cases was significantly higher than that in the AFP mRNA-negative cases ( = 0.0472). Postoperative AFP mRNA positivity was not related to very early recurrence (0-9 months) or multicentric liver carcinogenesis (>24 months).
AFP mRNA positivity in the peripheral blood was elevated after hepatectomy, and the elevation depended on the tumor location. AFP mRNA positivity might contribute to recurrence-free survival 9-24 months after hepatectomy.
背景/目的：甲胎蛋白（AFP）信使核糖核酸（mRNA）表达细胞是肝细胞癌循环肿瘤细胞的候选对象。我们分析了门静脉血、外周血和腹腔灌洗样本，以检测AFP mRNA表达细胞的存在，并探讨它们与转移的关系。
我们检测了手术期间获取的112组门静脉和外周血样本以及61份腹腔灌洗样本中的AFP mRNA表达。我们评估了AFP mRNA阳性患者的阳性率变化、相关背景因素和复发率。
肝切除术中，外周血样本中AFP mRNA阳性率变化显著，而门静脉血和腹腔灌洗样本中的变化相似。肿瘤位置是与AFP mRNA阳性相关的唯一因素。肝切除术后9至24个月，AFP mRNA阳性患者的复发率高于阴性患者。在此有限时间段内，AFP mRNA阳性病例的复发率显著高于AFP mRNA阴性病例（P = 0.0472）。术后AFP mRNA阳性与极早期复发（0至9个月）或多中心肝癌发生（>24个月）无关。
肝切除术后外周血中AFP mRNA阳性率升高，且升高取决于肿瘤位置。AFP mRNA阳性可能有助于肝切除术后9至24个月的无复发生存。
