Albumin messenger RNA as a marker of circulating hepatocytes in hepatocellular carcinoma.

Background/aims: Hepatocellular carcinoma is one of the most frequent malignancies. Liver transplantation is theoretically the treatment of choice because it eliminates both the hepatocellular carcinoma and the cirrhosis. High frequency of relapse observed after liver transplantation may be explained by the existence of undetectable metastasis before transplantation. The aim of this study was to determine whether albumin messenger RNA (mRNA), a specifically hepatocyte-expressed gene, could be a marker of metastasis in hepatocellular carcinoma.

Methods: Albumin mRNA from circulating malignant hepatocytes was detected in the blood by reverse transcription followed by enzymatic amplification.

Results: Albumin mRNA was found in the blood of 3 patients with histologically proven metastatic hepatocellular carcinoma and in 9 of 21 patients with hepatocellular carcinoma and undetectable metastases, giving a percentage rate of 43, similar to the relapse rate following liver transplantation for hepatocellular carcinoma. None of the 8 patients with secondary liver cancer had detectable albumin mRNA.

Conclusions: These results suggest that patients with hepatocellular carcinoma and no detectable albumin mRNA in the blood may be a subgroup with a low risk of relapse following liver transplantation.