NONSPECIFICITY OF MESSENGER-RNA OF ALPHA-FETOPROTEIN IN PERIPHERAL-BLOOD IN DETECTING EARLY SPREAD OF HEPATOCELLULAR-CARCINOMA IN BLACK-AFRICANS

Awareness of early spread of hepatocellular carcinoma is crucial in se lecting patients for surgical intervention. alpha-Fetoprotein is widel y used as a serum marker for hepatocellular carcinoma. Our aim was to evaluate the specificity of alpha-fetoprotein-mRNA transcription in ce lls in the peripheral blood for diagnosing early spread of hepatocellu lar carcinoma in black Africans. alpha-Fetoprotein-, albumin- and prot hrombin-mRNA were detected in peripheral blood mononuclear cells by re verse transcription-polymerase chain reaction, alpha-Fetoprotein-mRNA was shown in peripheral blood mononuclear cells in 53% (35/66) of pati ents with hepatocellular carcinoma, but also in 45% (10/22) of healthy blacks, 64% (14/22) of black patients with acute hepatitis, 55% (11/2 0) of those with chronic hepatitis or cirrhosis and 75% (9/12) of thos e with hepatic metastases (from a number of primary sites). Specificit y of albumin- and prothrombin-mRNA was better than that of alpha-fetop rotein-mRNA, although the sensitivity was reduced. The corresponding p revalence of albumin-mRNA for each group of patients or controls was 3 0% (20/66), 9% (2/22), 41% (9/22), 10% (2/20), and 17% (2/12), respect ively, and for prothrombin-mRNA 27% (18/66), 4.5% (1/22), 27% (6/22), 20% (4/20) and 17% (2/12), respectively. We conclude that the non-spec ificity of alpha-fetoprotein-mRNA transcription in peripheral blood in recognizing malignant hepatocytes in the circulation severely limits its usefulness in diagnosing the early spread of hepatocellular carcin oma in black Africans.