Detection of MAGE-1, MAGE-3 and AFP mRNA as multimarker by real-time quantitative PCR assay: a possible predictor of hematogenous micrometastasis of hepatocellular carcinoma.

BACKGROUND/AIMS: The aim of this study was to explore the relationship between MAGE-1, MAGE-3 and AFP mRNA in the peripheral blood of patients with hepatocellular carcinoma and micrometastasis in circulation, real-time quantitative-PCR (real-time Q-PCR) assay was applied to detect the expression of the multimarker. METHODOLOGY: Peripheral blood samples were obtained from 86 patients with hepatocellular carcinoma (HCC) and real-time Q-PCR technique was used to detect the MAGE-1, MAGE-3, and AFP mRNA in the blood. RESULTS: In 86 tumor specimens, the positivity for MAGE-1, MAGE-3, and AFP genes was 34.9% (30/86), 60.5% (52/86) and 69.8%(60/86) respectively, and all specimens expressed at least one marker. MAGE-1, MAGE-3, and AFP transcripts were detected in 12 (14.0%),18 (20.1%) and 29 (33.7%) of 86 blood specimens from hepatocellular carcinoma patients, respectively, while 45 specimens (52.3%) were positive for at least one marker. In addition, MAGE-1, MAGE-3 and AFP gene transcripts were not detected in any peripheral blood specimens from 25 chronic liver disease patients and 28 normal healthy volunteers. The positive rate correlated with the TNM clinical stages, extrahepatic metastasis and portal vein carcinothrombosis (p<0.05). No correlation was found between tumor size, tumor number, differentiation, serum a-fetoprotein (AFP) and the positive rate. CONCLUSIONS: Our results indicate that a multimarker real-time Q-PCR assay with cancer-specific markers such as MAGE-1 and MAGE-3 in combination with a hepatocyte-specific AFP marker may be a promising diagnostic tool for monitoring hepato-cellular carcinoma patients with better sensitivity and specificity.