Relationship between pre-transplantation α-fetoprotein messenger RNA expression in peripheral blood with tumor recurrence and survival rate in HCC patients / 第二军医大学学报

ABSTRACT

Objective: To assess the relationship between pre-transplantation α-fetoprotein messenger (AFP) RNA expression in peripheral blood with tumor recurrence and survival rate in HCC patients. Methods: Thirty-one HCC patients receiving in situ liver transplantation from Feb. 2003 to Feb. 2004 were included in this study. Real-time quantitative RT-PCR was used to determine the expression level of AFP RNA in peripheral blood of all patients. All the cases were followed up for tumor recurrence and survival rate. The SPSS 12.0 software was used to analyze the relationship between AFP mRNA expression with tumor recurrence and survival rate. Results: Ten of the 31 patients were positive of AFP mRNA, with the quantity being 57 to 10 400 copies/μg RNA (median value 360 copies/ μg RNA). Patients' Child-pugh grade, tumor size, tumor number, and tumor Edmood grade were not related to pre-transplantation AFP mRNA expression. Patients of pTNM III-IV stages had a significantly higher AFP mRNA expression than those of pTNM I-II stages (P=0.001); patients with vascular invasion had a significantly higher expression than those without (P=0.029). Patients who were negative of AFP mRNA before transplantation had a significantly higher survival rate than those positive of AFP mRNA. Conclusion: The results suggest that the pre-transplantation levels of AFP mRNA in peripheral blood may be a risk factor for recurrence and/or metastasis after transplantation in HCC patients; it may also be an indicator for extra-hepatic micrometastasis before transplantation and can be used for predicting prognosis.