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OBJECTIVE To explore the relationship between multimarker detection of MAGE-1, MAGE-3 and AFP mRNAs in the peripheral blood of patients with hepatocellular carcinoma and micrometastasis using a real-time quantitative-PCR (real-time Q-PCR) assay.METHODS Peripheral blood samples were obtained from control subjects and 86 patients with hepatocellular carcinoma(HCC). Real-time Q-PCR was used to detect MAGE-1, MAGE-3,and AFP mRNAs in the blood cells.RESULTS In 86 tumor specimens, the positivity for MAGE-1,MAGE-3, and AFP genes was respectively 34.9% (30/86), 60.5%(52/86) and 69.8% (60/86). All specimens expressed at least one marker. MAGE-1, MAGE-3, and AFP transcripts were detected respectively in 12 (14.0%), 18 (20.1%) and 29 (33.7%) of the 86blood specimens from hepatocellular carcinoma patients, while 45 specimens (52.3%) were positive for at least one marker. In addition, MAGE-1, MAGE-3 and AFP gene transcripts were not detected in any peripheral blood specimens from 25 chronic liver disease patients and 28 normal healthy volunteers. The positive rate correlated with the TNM clinical stages, extrahepatic metastasis and portal vein carcinothrombosis (P ＜ 0.05). No correlation was found between tumor size, tumor number,differentiation, serum a-fetoprotein (AFP) and the positive rate.CONCLUSION Our results indicate that a multimarker real-time Q-PCR assay with cancer-specific markers such as MAGE-1and MAGE-3 in combination with a hepatocyte-specific AFP marker may be a promising diagnostic tool for monitoring hepatocellular carcinoma patients with better sensitivity and specificity.