Detection of isolated disseminated tumor cells in bone marrow and blood samples of patients with hepatocellular carcinoma.

Content Provider	Semantic Scholar
Author	Kienle, Peter Weitz, Jürgen Klaes, Ruediger Koch, Michael Benner, Axel Lehnert, Thomas Herfarth, Christian Doeberitz, Magnus Von Knebel
Copyright Year	2000
Abstract	BACKGROUND Patients with hepatocellular carcinoma (HCC) often develop recurrences after curative resection or liver transplantation. Therefore, tumor cell dissemination must have occurred preoperatively or intraoperatively. Current staging methods cannot reliably detect micrometastasis. Reverse transcription-polymerase chain reaction (RT-PCR) for alpha-fetoprotein (AFP) has been used to detect circulating liver cancer cells, but results in blood samples have been contradictory. HYPOTHESIS AFP-RT-PCR is a specific and sensitive assay for the detection of disseminated tumor cells in central venous blood and bone marrow samples of patients with HCC and has prognostic relevance. DESIGN Prospective consecutive series. SETTING University hospital. PATIENTS AND METHODS We performed preoperative, intraoperative, and postoperative analyses of central venous blood samples and preoperative analysis of bone marrow samples of patients with HCC and patients without malignant disease, using a modified AFP-RT-PCR method. Preoperative serum AFP levels were measured. Clinical follow-up ranged from 4 to 20 months. MAIN OUTCOME MEASURES Sensitivity and specificity of AFP-RT-PCR, correlation of AFP-RT-PCR results to tumor stage and tumor recurrence. RESULTS In serial dilution experiments, 50 AFP-expressing HepG2 cells were detected in 10 mL of blood. Peripheral blood samples of 20 healthy volunteers and bone marrow samples of 21 patients with benign diseases consistently tested negative for AFP, whereas 4 of 24 patients with HCC showed AFP expression in bone marrow samples. All these patients had advanced disease; however, correlation of positive RT-PCR results to tumor stage was not significant (P = .07). One of the 4 AFP-positive patients developed an intrahepatic recurrence soon after liver transplantation. Central venous blood of patients with HCC (n = 24) and patients with benign liver diseases (n = 13) equally demonstrated AFP-expressing cells. There was no correlation of RT-PCR results to serum AFP levels. CONCLUSIONS Perioperative screening for micrometastasis in bone marrow of patients with HCC is sensitive and specific with AFP-RT-PCR and may have prognostic relevance. Alpha-fetoprotein is not a suitable marker for the detection of tumor cells in central venous blood samples.
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Alternate Webpage(s)	https://archsurg.jamanetwork.com/journals/SURG/articlepdf/390510/soa9039.pdf
PubMed reference number	10668884v1
Volume Number	135
Issue Number	2
Journal	Archives of surgery
Language	English
Access Restriction	Open
Subject Keyword	Adrenergic alpha-Agonists Biomarkers, Tumor Blood specimen Bone Marrow Fetal Proteins Intrahepatic Cholestasis Liver and Intrahepatic Biliary Tract Carcinoma Liver carcinoma Liver diseases Neoplasms Neoplastic Cell Patients Reverse Transcriptase Polymerase Chain Reaction Reverse Transcription Transplantation of liver Tumor stage alpha-Mannosidosis cancer cell malignant disease
Content Type	Text
Resource Type	Article