Tumor Recurrence Following Liver Transplantation for Hepatocellular Carcinoma: Role of Tumor Proliferation Status
Tumor Recurrence Following Liver Transplantation for Hepatocellular Carcinoma: Role of Tumor Proliferation Status
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DOI：
10.1002/lt.21993
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发表时间：
2010-03-01
影响因子：
4.6
通讯作者：
Alexander, Graeme J. M.
中科院分区：
文献类型：
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作者：
Marshall, Aileen E.;Rushbrook, Simon M.;Alexander, Graeme J. M.
目前选择肝细胞癌患者进行肝移植的依据是肿瘤的大小和数量，以将复发风险降至最低。这些标准衡量肿瘤体积，但可能不能准确反映肿瘤行为。肿瘤行为的生物标志物可以进一步帮助患者选择。本研究的目的是确定与肿瘤复发风险高相关的因素，并评估肿瘤增殖状态对移植后复发的作用。本文回顾了67例肝细胞癌移植患者的病理资料。用微染色体维持蛋白-2(MCM-2)和细胞周期蛋白A(Cyclin A)检测肿瘤的增殖情况，对影响肿瘤复发和总生存期的因素进行Cox回归分析，根据与选择标准的符合性评价无复发生存期，多因素分析显示肿瘤大小、血管侵犯和MCM-2最高表达与肿瘤复发有关(P<；0.02)无复发生存率显著高于那些无血管侵犯的患者，那些符合米兰、加州大学旧金山分校(UCSF)或最多七项选择标准的患者，以及那些MCM-2表达较低的患者。结论：符合米兰、加州大学旧金山分校或最多七项选择标准的肿瘤患者，肝移植后的复发率较低。血管侵犯和肿瘤增殖状态与复发风险无关，与肿瘤大小无关。2010年。(C)2010年AASLD。
The selection of patients with hepatocellular carcinoma for liver transplantation is currently based on the size and number of tumors to minimize the risk of recurrence These criteria measure tumor bulk but may not reflect tumor behavior accurately A biological marker of tumor behavior could aid with patient selection further The aims of this study were to determine factors associated with a higher risk of tumor recurrence and to assess the role of tumor proliferation status with respect to recurrence following transplantation Pathological data on 67 patients who underwent transplantation for hepatocellular carcinoma were reviewed, and tumor proliferation was assessed by minichromosome maintenance protein-2 (MCM-2) and cyclin A expression A Cox regression analysis of factors related to tumor recurrence and overall survival was carried out Recurrence-free survival was assessed according to compatibility with selection criteria, vascular invasion, and proliferation status Tumor size, vascular invasion, and highest MCM-2 expression were associated with tumor recurrence by multivariate analysis (P < 0 02) Recurrence-free survival was significantly better for those patients without vascular invasion, those who were within the Milan, University of California San Francisco (UCSF), or Up-to-Seven selection criteria, and those with lower expression of MCM-2 In conclusion, tumors meeting the Milan, UCSF, or Up-to-Seven selection criteria had a lower rate of recurrence following liver transplantation Vascular invasion and tumor proliferation status were associated with the risk of recurrence independently of tumor size Biopsy of larger tumors to assess proliferative activity could identify those at lower risk of recurrence who could also benefit from liver transplantation Liver Transpl 16:279-288. 2010. (C) 2010 AASLD.