Published in Cancer Detection and Prevention 1993; 17(1).

Detection of human albumin mRNA by polymerase chain reaction as a marker of circulating hepatocytes in hepatocellularcarcinoma

Barbu MD, V.1, Hillaire MD, S.1, Boucher MD, E.2, Moukhtar PhD, M.3, Poupon MD, R.1.

1 Hopital Saint-Antoine, Paris, 2 Hopital Pontchaillou, Rennes, 3 INSERM U113, Paris , France.

Hepatocellular carcinoma (HCC), one of the most frequent malignancies develops mainly on cirrhosis. The treatment of choice is theoretically liver transplantation. However, tumor recurrence post-transplantation occurs in more than 50 % of cases due to the existence of undetectable metastasis prior to surgery. The aim of the study was to develop a sensitive marker of micro-metastasis in HCC. We chose to detect albumin mRNA from heparinized blood samples by reverse transcription and polymerase chain reaction (PCR) for the following rationale: a) hepatocytes are the only cells transcribing albumin mRNA. b) dissemination of these cells in the bloodstream is a necessary step of development of metastasis. This technique allowed the detection of 10 hepatocytes in 0.5 ml blood sample. The data are given in the table. Two patients with cirrhosis were PCR negative.

Patients Albumin mRNA HCC+proven metastasis 3/3 HCC +no proven metastasis 9/21 Secondary liver tumors 0/8
Our results suggest that this method could permit to identify a subgroup of patients with HCC, that could be transplanted without or with a low recurrence risk.

Paper presented at the International Symposium on Genetic Factors in Predictive and Preventive Oncology; Nice, France; March 14-16, 1993; in the section on Prognostic Indicators.