Background/aims: The presence of alpha-fetoprotein (AFP)mRNA in the peripheral blood of patients with HCC suggested that carcinoma cells still existed. We investigated the influence of an alternation of human AFPmRNA perioperatively detected in peripheral blood in matters of recurrence, prognosis and operative performance.
Methodology: Thirty-three patients with HCC were enrolled for this study. AFPmRNA in peripheral blood before the operation, and on 1, 3, 7, 14, 21 and 28 post-operative days was examined by means of the reverse-transcriptase polymerase chain reaction (RT-PCR).
Results: In 18 of 33 patients (54.5%) with HCC, AFPmRNA was detected in peripheral blood pre-operatively. Ten of 22 (45.4%) who were detected with AFPmRNA in peripheral blood during the perioperative period were diagnosed with intrahepatic recurrence or distant metastasis within 12 months post-operatively. In contrast, 10 (90.8%) of 11 patients who were not detected with AFPmRNA in peripheral blood anytime during hospitalization were diagnosed as free of intrahepatic recurrence or distant metastases within 9 months after the operation.
Conclusions: These results suggested that an alternation of AFPmRNA from HCC patients' peripheral blood during the perioperative period by means of this technique may be a practical tool in the detection of early recurrence or distant metastases after surgery.