Effect of surgical margin on recurrence based on preoperative circulating tumor cell status in hepatocellular carcinoma.
Effect of surgical margin on recurrence based on preoperative circulating tumor cell status in hepatocellular carcinoma.
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基于肝细胞癌术前循环肿瘤细胞状态的手术切缘对复发的影响。
DOI：
10.1016/j.ebiom.2020.103107
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发表时间：
2020-12
期刊：
影响因子：
11.1
通讯作者：
Yang XR
中科院分区：
文献类型：
--
作者：
Zhou KQ;Sun YF;Cheng JW;Du M;Ji Y;Wang PX;Hu B;Guo W;Gao Y;Yin Y;Huang JF;Zhou J;Fan J;Yang XR
切除术后高复发率严重恶化了肝细胞癌（HCC）的预后。本研究旨在探讨循环肿瘤细胞（CTC）是否有助于确定肝癌患者的适当肝切除术切缘。接受肝切除术的HCC患者入组训练（n=117）或验证（n=192）队列，然后分类为CTC阳性（CTC≥1）或CTC阴性（CTC=0）。在训练队列中使用标准化病理取样方法来量化微血管浸润（mVI）和距肿瘤最远的mVI（FMT）。CTC数与mVI数（r=0.655，P<0.001）和FMT（r=0.495，P<0.001）呈正相关。CTC阳性组的mVI计数（P=0.032）和FMT（P=0.008）高于CTC阴性组。在CTC阳性组中，手术切缘>1 cm可独立防止早期复发（培训队列，P=0.004;验证队列，P=0.001），与手术切缘≤1 cm相比，早期复发率较低（培训队列，20.0%与65.1%，P=0.005;验证队列，36.4%与65.1%，P=0.003）。切缘>1 cm与≤1 cm的患者术后肝功能无差异。当使用0.5 cm或1 cm作为阈值时，手术切缘大小对CTC阴性患者术后早期HCC复发的影响最小。术前CTC状态可预测HCC患者的mVI严重程度，是确定最佳手术切缘大小的潜在因素，以确保疾病根除和保护肝功能。CTC阳性患者的手术切缘应大于1 cm。对本研究做出贡献的资助机构的完整列表可以在致谢部分找到。
High rates of recurrence after resection severely worsen hepatocellular carcinoma (HCC) prognosis. This study aims to explore whether circulating tumor cell (CTC) is helpful in determine the appropriate liver resection margins for HCC patients. HCC patients who underwent liver resection were enrolled into training (n=117) or validation (n=192) cohorts, then classified as CTC-positive (CTC≥1) or CTC-negative (CTC=0). A standardized pathologic sampling method was used in the training cohort to quantify microvascular invasion (mVI) and the farthest mVI from the tumor (FMT). CTC number positively correlated with mVI counts (r=0.655, P<0.001) and FMT (r=0.495, P<0.001). The CTC-positive group had higher mVI counts (P=0.032) and greater FMT P=0.008) than the CTC-negative group. In the CTC-positive group, surgical margins of >1 cm independently protected against early recurrence (training cohort, P=0.004; validation cohort, P=0.001) with lower early recurrence rates (training cohort, 20.0% vs. 65.1%, P=0.005; validation cohort, 36.4% vs. 65.1%, P=0.003) compared to surgical margins of ≤1 cm. No differences in postoperative liver function were observed between patients with margins >1 cm vs. ≤1 cm. Surgical margin size minimally impacted early postoperative HCC recurrence in CTC-negative patients when using 0.5 cm or 1 cm as the threshold. Preoperative CTC status predicts mVI severity in HCC patients and is a potential factor for determining optimal surgical margin size to ensure disease eradication and conserve liver function. A surgical margin of >1 cm should be achieved for patients with positive CTC. A full list of funding bodies that contributed to this study can be found in the Acknowledgement section.
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影响因子：
81.5
作者：
Llovet, Josep M.;Zucman-Rossi, Jessica;Gores, Gregory
通讯作者：
Gores, Gregory
用于循环肝细胞癌细胞检测的双选择性和双增强 SERS 纳米探针策略
影响因子：
4.3
作者：
Pang, Yuanfeng;Wang, Chongwen;Sun, Zhiwei
通讯作者：
Sun, Zhiwei
DOI：
10.1126/science.1235226
发表时间：
2013-09-13
期刊：
Science (New York, N.Y.)
影响因子：
--
作者：
Plaks V;Koopman CD;Werb Z
通讯作者：
Werb Z
影响因子：
9
作者：
Balzan, S;Belghiti, J;Durand, F
通讯作者：
Durand, F
影响因子：
9
作者：
Allard, Marc-Antoine;Adam, Rene;Vibert, Eric
通讯作者：
Vibert, Eric