Abstract:

Objective To explore the value of glypican-3 (GPC-3) mRNA and paternally expressed 10 (PEG10) mRNA in peripheral blood in diagnosis of metastasis in hepatocellular carcinoma (HCC). Methods With SYBR Green I as fluorescence signal, real-time fluorescent quantitative reverse transcription-polymerase chain reaction was employed to detect the expression of GPC-3 mRNA and PEG10 mRNA in peripheral blood from patients with HCC with metastasis (n=8), HCC without metastasis (n=12) and hepatic cirrhosis (n=11), and receiver operator characteristics curve (ROC) and specific parameters were adopted to analyse their value in predictive and exclusive diagnosis. Results The expression of GPC-3 mRNA and PEG10 mRNA in HCC with metastasis was significantly higher than that in HCC without metastasis and in hepatic cirrhosis (P<0.05), while there was no significant difference in the expression of GPC-3 mRNA and PEG10 mRNA between HCC without metastasis and hepatic cirrhosis. In single test, the sensitivities in the differential diagnosis between HCC with metastasis and HCC without metastasis were 66.7% for GPC-3 mRNA and 72.2% for PEG10 mRNA, and the specificities were 91.7% and 91.7%, respectively. The areas under ROC were 0.748 for GPC-3 mRNA and 0.812 for PEG10 mRNA. With two markers in parallel test, the sensitivity, specificity, negative likelihood and diagnostic accuracy were 90.7%, 84.0%, 0.11 and 83.3%, respectively. In serial test, the sensitivity, specificity, positive likelihood and diagnostic accuracy were 60.5%, 98.7%, 45.5 and 73.3%, respectively. Conclusion Detection of GPC-3 mRNA and PEG10 mRNA in peripheral blood may help to predict blood metastasis and extrahepatic metastasis of HCC, and PEG10 mRNA works better than GPC-3 mRNA. The serial test of GPC-3 mRNA and PEG10 mRNA is helpful to the predictive diagnosis of peripheral blood metastasis of HCC.

Key words: hepatocellular carcinoma, metastasis, glypican-3 gene, paternally expressed gene 10, ROC curve, combined test