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Combined serum hepatoma-specific alpha-fetoprotein and circulating alpha-fetoprotein-mRNA in diagnosis of hepatocellular carcinoma |
Wei Wu, Deng-Fu Yao, Yong-Mei Yuan, Ji-Wei Fan, Xiu-Feng Lu, Xiao-Hua Li, Li-Wei Qiu, Lei Zong and Xin-Hua Wu |
Nantong, China
Author Affiliations: Research Center of Clinical Molecular Biology, Affiliated Hospital of Nantong University, Nantong 226001, China (Wu W, Yao DF, Yuan YM, Fan JW, Lu XF, Li XH, Qiu LW, Zong L and Wu XH)
Corresponding Author: Deng-Fu Yao, MD, PhD, Research Center of Clinical Molecular Biology, Affiliated Hospital of Nantong University, Nantong 226001, China (Tel: 86-513-85861539; Fax: 86-513-85052523; Email: yaodf@ahnmc.com) |
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Abstract BACKGROUND: Hepatocellular carcinoma (HCC) is one of the most common malignant tumors worldwide, its prognosis is poor, and early detection is of utmost importance. Although alpha-fetoprotein (AFP) is a useful marker for detecting and monitoring HCC development, the false-negative or false-positive rates with AFP alone may be as high as 30%-40% for patients with small HCCs. To enhance the specificity and accuracy of AFP measurements for HCC, we analyzed AFP expression states in livers, detected the hepatoma-specific AFP (HS-AFP) fraction and AFP-mRNA from peripheral blood mononuclear cells, and explored their clinical implications for HCC diagnosis.
METHODS: AFP expression and hepatocyte distributions in liver specimens were investigated by an immunohistoche-mical assay. Total RNAs were extracted from circulating blood, synthesized to cDNA through random primers and reverse transcriptase, and fragments of the AFP gene were amplified by a nested-PCR assay. The HS-AFP fraction was separated by lectin-affinity chromatography and its level was detected by radioimmunoassay.
RESULTS: The incidence of AFP was 73.3% in HCC tissues and its expression in HCCs with moderate or low differentiation was significantly stronger than that of HCCs with high differentiation (P<0.05). The incidence of AFP gene fragments was 100% in HCCs, and 60% in paracancerous tissues (P<0.01). In the HCC and liver cirrhosis groups, the incidence of HS-AFP was 91.7% and 18% (P<0.01), and of AFP-mRNA was 56.7% and 16% (P<0.01), respectively, and neither was found in controls. HS-AFP or AFP-mRNA was not significantly related to size or number of HCC, but to its differentiation, metastasis, and relapse (P<0.05).
CONCLUSIONS: Different AFP expression is present in different parts of HCC tissues. HS-AFP and AFP-mRNA fragments improve sensitivity and specificity, and both are useful markers to diagnose HCC or monitor metastasis and relapse.
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Cite this article: |
Wu W,
Yao DF,
Yuan YM,
et al.
Combined serum hepatoma-specific alpha-fetoprotein and circulating alpha-fetoprotein-mRNA in diagnosis of hepatocellular carcinoma.
Hepatobiliary Pancreat Dis Int
2006;
5(4):
538-544. DOI:
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URL: |
http://dx.doi.org/ OR http://www.hbpdint.com/EN/Y2006/V5/I4/538 |
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