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ObjectiveThe objective of this study was to analyze the specificity of detecting liver tumor cell dissemination by alpha-fetoprotein (AFP) mRNA in peripheral blood. Summary Background DataAlpha-fetoprotein mRNA has been used for the detection of circulating micrometastatic tumor foci of hepatocellular carcinoma (HCC); however, the interpretation of the results has been equivocal. MethodsSixty-four consecutive patients with malignant HCC (n = 20), liver metastases (n = 27), or nonmalignant (n = 17) liver diseases undergoing partial or total hepatectomy and orthotopic liver transplantation were included in this prospective study from January to July 1995. Peripheral blood samples were obtained before surgery, during surgery, and after surgery (range, 6-15 months). Total mRNA was extracted from nucleated cells, and cDNA synthesis and polymerase chain reaction amplification (nested polymerase chain reaction in one tube) were performed with specific AFP primers. ResultsPreoperative AFP mRNA was detected in 20 patients (17%), of which 5 of 20 had HCC. lntraoperative assessment showed positive AFP mRNA values in a total of 34 patients (53%) with various causes, of which 8 of 20 (40%) had HCC, 17 of 27 (63%) had other malignancies, and 9 of 17 (53%) had nonmalignant diseases. Recurrent tumor in patients with HCC occurred in four cases after surgery (range, 6-15 months) and did not correlate with AFP mRNA positivity before surgery, during surgery, or after surgery. ConclusionsAlpha-fetoprotein mRNA in peripheral blood is not a specific marker of circulating micrometastases from HCC, especially in the context of surgical treatment of HCC. 43

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Background:We evaluated a new, automated multicapillary zone electrophoresis (CE) instrument (Capillarys ® , 4.51 software version; Sebia) for human serum protein analysis. Methods: With the Capillarys ␤1-␤2؉® reagent set, proteins were separated at 7 kV for 4 min in 15.5 cm ؋ 25 m fused-silica capillaries (n ‫؍‬ 8) at 35.5°C in a pH 10 buffer with online detection at 200 nm. Serum samples with different electrophoretic patterns (n ‫؍‬ 265) or potential interference (n ‫؍‬ 69) were analyzed and compared with agarose gel electrophoresis (AGE; Hydrasys ® -Hyrys ® , Hydragel protein(e) 15/30 ® reagent set; Sebia). Results: CVs were <3.5% for albumin, <11% for ␣ 1 -globulin, <4.1% for ␣ 2 -globulin, <7.4% for ␤-globulin, and <5.8% for ␥-globulin (3 control levels); measured throughput was 60 samples/h. In patients without paraprotein (n ‫؍‬ 116), the median differences between CE and AGE were ؊5.4 g/L for albumin, 4.0 g/L for ␣ 1 -globulin, 0.7 g/L for ␣ 2 -globulin, 0.6 g/L for ␤-globulin (P <0.001 for all fractions), and ؊0.1 g/L for ␥-globulin (not significant). More samples had at least one ␥-migrating peak detected by CE (n ‫؍‬ 135 vs 130; paraprotein detection limit, ϳ0.5-0.7 g/L), but fewer were quantified (n ‫؍‬ 84 vs 91) because of ␥-to ␤-migration shifts. There was a 1.2 g/L median difference between CE and AGE for ␥-migrating paraprotein quantification (n ‫؍‬ 69; P <0.001). Several ultraviolet-absorbing substances (lipid

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