【Abstract】Objective To explore the changes of expression of AFP mRNA in human hepatocellular carcinoma （HCC） tissues after oral Xeloda therapy.Methods Total RNA was extracted from HCC tissue samples collect after operation and nested reverse transcription polymerase chain reaction （RT-nested PCR） assay was performed to determine the expression of AFP mRNA in this study.Results The final product of AFP mRNA amplified by RT-PCR was 174 bp and by RT-nested PCR was 101 bp. The AFP mRNA is positive in 12 of 21 patients (positive rate 57.14%) amplified by RT-nested PCR assay in Xeloda treatment group which is much lower than control group: 18 of 20 patients (positive rate 90.00%),P＜0.05.The serum AFP value of Xeloda treatment group 〔(23.2±12.8) μg/L〕 is much lower than that of control group 〔(39.6±24.3) μg/L〕 four weeks after operation (P＜0.05). However, There was no difference between two groups in serum AFP value before operation.Conclusion Xeloda can effectively suppress the expression of AFP mRNA in human HCC tissues and lower it’s product serum AFP value.The clinical application of Xeloda in HCC patients deserve further study.
ObjectiveTo evaluate the effects of high intensity focused ultrasound (HIFU) on hepatic cancer cells spreading in blood.Methods AFP mRNA in peripheral blood of 19 patients with hepatocellular carcinoma was detected before and after HIFU therapy by RTPCR.Results①Before HIFU therapy, 11 of 19 cases were AFP mRNA positive (57.9%), while the control group were all negative. AFP mRNA was correlated with some clinical parameters such as serum AFP level, tumor size, portal vein embolism and extrahepatic metastasis (P＜0.05). ②In 8 cases with preoperative AFP mRNA negative, only 2 cases became AFP mRNA positive immediately after therapy, and one of the 2 cases became negative again after 72 hours. One week after HIFU therapy, the AFP mRNA positive rate (31.6%) was much lower than the preoperative positive rate (57.9%), but there was no statistical significance (Pgt;0.05). ③After one week of HIFU therapy, the AFP mRNA positive rate of the group with tumor size less than 8 cm was much lower than that of tumor size larger than 8 cm (P＜0.05). ConclusionHIFU may reduce the spreading of hepatocellular carcinoma cells in blood. It is effective for patients with tumor size less than 8 cm.
Objective To systematically evaluate AFP as the diagnostic standard for Chinese primary liver cancer (PLC). Methods A comprehensive electronic search and additional manual tracking were performed to retrieve relevant studies on AFP in diagnosis of Chinese PLC. All studies were divided into three groups according to the cutoff value of AFP: 20 or 25 ?g/L, 200 ?g/L, 400 ?g/L (Groups 1, 2, and 3, respectively). The data about the accuracy of the included studies were extracted for further heterogeneity studies; statistical pooling and SROC (summary receiver operating characteristics) were analyzed using MetaDisc 1.4 software. Results Twenty studies which were selected from 1,062 references met the inclusion criteria. Heterogeneity (except for threshold effect) was found within the three groups. A Meta-analysis was performed using the random effect model. Compared with the other two groups, the specificity of Group 3 (AFP 400 ?g/L) was the highest (0.977, 95%CI 0.967 to 0.985) and sensitivity was the lowest (0.422, 95%CI 0.403 to 0.441). The values of LR+ and dOR were lower than those of Group 2 (AFP 200?g/L) (17.691: 19.669; 32.820: 53.599, respectively). Area under curve (AUC) of SROC and Q index of Group 3 were also lower than those of Group 2 (0.6575: 0.832 3; 0.633 8: 0.782 2, respectively). Conclusion Four-hundred ?g/L of AFP as the diagnostic standard for PLC is not good enough, and we suggest that 200 ?g/L may be better than 400 ?g/L for PLC diagnosis.
Objective To evaluate the accuracy and quality of diagnostic test of Electrochemiluminescence immunoassay (ECLIA) in detecting A-fetal protein (AFP) for the diagnosis of liver cancer in Chinese patients. Methods We searched Chinese Biological Medicine Database (CBM, 1978 to 2005) and China National Knowledge Infrastructure (CNKI, 1994 to 2005). Diagnostic tests of ECLIA in detecting AFP for the diagnosis of liver cancer were included. Data were extracted, and the quality of included studies was evaluated according to the six criteria of diagnostic tests. Results Forty-eight studies were identified, but only 6 were included and none mentioned the indices about the accuracy. Conclusion The number of studies of ECLIA in detecting AFP for the diagnosis of liver caner is few and the quality is poor. We cannot draw the conclusion that ECLIA is better for sensitivity and specificity.
ObjectiveTo evaluate the prognosis value of oncoprotein metadherin (MTDH) in alpha fetoprotein (AFP)negative hepatocellular carcinoma (HCC) patients following curative hepatectomy. MethodsThe expression of MTDH protein in 152 AFP negative HCC patients underwent curative hepatectomy from 2007 to 2010 in this hospital was detected by immunohistochemical stain. Clinicopathologic data for these patients were analyzed. Survival analysis was evaluated with Kaplan-Meier method and log-rank test to compare survival difference. Cox proportional hazard model analysis was used to assess prognostic significance of MTDH in AFP negative HCC patients. ResultsThe rate of MTDH high expression in the AFP negative HCC tissue was 60.53% (92/152). MTDH high expression was associated with tumor diameter (P=0.029), Edmondson grade (P=0.032), microvascular invasion (P=0.024), or tumor recurrence (P=0.014). Univariate and Cox proportional hazard model analysis showed that high expression of MTDH was correlated with the poor survival in AFP negative HCC patients (P=0.002, P=0.017). ConclusionMTDH is an independent predictor for survival in AFP negative HCC patients after curative hepatectomy.