α-fetoprotein,vascular endothelial growth factor receptor-1 and early recurrence of hepatoma

AIM：To investigate whether α-fetoprotein （AFP） and vascular endothelial growth factor receptor （VEGFR）-1 correlate with early recurrence of hepatoma/hepatocel-lular carcinoma （HCC）.METHODS：From 2000 to 2005,114 consecutive pa-tients with HCC underwent primary curative hepatecto-my.The mean age was 60.7 （8.7） years and 94 patients were male.The median follow-up period was 71.2 mo （range：43-100 mo）.Immediately prior to commencing laparotomy,5 mL bone marrow was aspirated from thesternum and collected in citrate-coated test tubes.The initial 2 mL of bone marrow aspirate was discarded in each case.AFP mRNA and VEGFR-1 mRNA in the bone marrow and peripheral blood （BM-and PH-AFP mRNA and BM-and PH-VEGFR-1 mRNA,respectively） were measured by real-time quantitative reverse transcription polymerase chain reaction.As normal controls,VEGFR-1 mRNA in the bone marrow and peripheral blood was also measured in 11 living liver donors.These data were evaluated for any correlation with early recurrence,comparing clinical and pathological outcomes.RESULTS：The cut-off value of the BM-AFP mRNA and PH-AFP mRNA level in patients with HCC was set at 1.92 × 10-7 and zero,respectively,based on data from the controls.A total of 34 （29.8%） and six （5.4%） patients were positive for BM-AFP mRNA and PH-AFP mRNA,respectively.The BM-VEGFR-1 mRNA levels in all HCC patients were higher than those in the normal con-trols,and this was the case also for PH-VEGFR-1mRNA.The 25-percentile values for the BM-and PH-VEGFR-1 mRNA in HCC patients were used as the cut-off values for assigning the patients into two groups based on these transcript levels.The High group for BM-VEG-FR-1 mRNA contained 81 （71.1%） HCC cases and the Low group was assigned 33 （28.9%） patients.These numbers for PH-VEGFR-1mRNA were 78 （75.0%） and 26 （25.0%）,respectively.HCC recurred in 80 patients;in the remnant liver in 48 cases,in the remnant liver and remote tissue in 20,and in the remote tissue alone in 12.BM-AFP mRNA-positive cases showed a signifi-cantly higher rate of early recurrence （within 1 year of surgical treatment） compared with BM-AFP mRNA-negative patients （P=0.0091）.Patients were classified into four groups according to the level/status of their BM-VEGFR-1 and BM-AFP mRNA as follows：group A （n=23）,BM-VEGFR-1/BM-AFP mRNA=low/negative;group B （n=57） high/negative;group C （n=10） low/positive;group D （n=24）,high/positive.This classifi-cation was found to correlate with a recurrence of thisdisease within 1 year （P=0