Albumin mRNA in Peripheral Bloods as a Marker of Extrahepatic Metastasis in Patients with Hepatocellular Carcinoma

Koh, Moon Soo; Chung, Young Hwa; Song, Il Han; Choo, Youn Ho; Lee, Geun Chan; Park, Neung Hwa; An, Gae Soon; Kim, Jeong A; Lee, Yung Sang; Suh, Dong Jin; Yoo, Byung Chul

Abstract

BACKGROUND/AIMS: Albumin mRNA, one of hepatocyte-specific genes, in peripheral blood has been reported as a marker of circulating hepatocytes in hepatocellular carcinoma (HCC). We evaluated the correlation between albumin mRNA in peripheral blood and evident vascular invasion or extrahepatic metastasis of HCC, and characterized the tumor and clinical features of patients with HCC in association with albumin mRNA in circulation.
METHODS
We analyzed albumin m-RNA in peripheral blood of 62 patients with hepatocellular carcinoma, 18 patients with chronic viral hepatitis and 8 patients with metastatic liver cancer. Also, we compared the radiological, clinical and tumor characteristics o patients with hepatocellular carcinoma.
RESULTS
In 36 of 62 patients with HCC (58%), 5 of 18 patients with chronic viral hepatitis (28%) and none of patients with metastatic liver cancer (0%) albumin mRNA was detected in peripheral blood. We analysed 61 patients with HCC (35 positive and 26 negative for albumin mRNA in peripheral circulation). We did not examine the remaining one patient whose serum ALT level was above 200 IU/L to reduce the possibility of false positive resul by severe hepatic necrosis.
CONCLUSIONS
The HCC patients with albumin mRNA in peripheral blood were younger than those without it (55 +/-9 vs 50 +/-9; p=0.03). The rates of serum HBsAg positivity were higher in the patients with albumin mRNA in pheripheral blood than in those without it. Mos of HCC patients with extrahepatic metastasis (17/18; 84%), evident portal vein involvement (26/31 84%), and biliary invasion (9/9; 100%) had albumin mRNA in peripheral circulation. Albumin mRNA was detected more commonly in patients with tumor over 5 cm in diameter than in patients with tumor less 5 cm (76% vs 20%; p<0.001). Moreover, albumin mRNA was more commonly detected in infiltrative type of tumor than in nodular type (90% vs 43%; p<0.001).