An immune function assay predicts post-transplant recurrence in patients with hepatocellular carcinoma
An immune function assay predicts post-transplant recurrence in patients with hepatocellular carcinoma
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DOI：
10.1007/s00432-011-1014-0
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发表时间：
2011-10-01
影响因子：
3.6
通讯作者：
Zhou, Jian
中科院分区：
文献类型：
--
作者：
Cheng, Jian-Wen;Shi, Ying-Hong;Zhou, Jian
目的提出了一种新的免疫功能检测方法来监测器官移植后的免疫抑制。然而，关于其在肝移植患者肝细胞癌（HCC）中的作用的数据有限。在这项研究中，我们试图确定这种功能测定在评估肝移植受者感染、排斥和肿瘤复发风险方面的效用。方法采用免疫- know法测定105例肝移植受者342份全血样本中CD4 (+) T细胞产生的三磷酸腺苷（ATP）的数量，监测其免疫功能。我们对60例肝癌患者的移植后肿瘤复发与ATP值的关系进行了评估。对其他独立队列92例HCC受者的ATP值预测肿瘤复发进行前瞻性分析。结果肝移植受者感染（145.2 +/- 87.0 ng/ml）或急性排斥反应（418.9 +/- 169.5 ng/ml）的平均ATP值与稳定状态（286.6 +/- 143.9 ng/ml）的差异有统计学意义，P < 0.05。在发生肿瘤复发的HCC受者中，该数值显著低于未复发的受者（137.8 +/- 66.4 vs. 289 +/- 133.9 ng/ml, P < 0.01）；预测移植后肿瘤复发的最佳阈值为175 ng/ml。与低免疫组（ATP 175 ng/ml）相比，无病生存期明显提高（P < 0.01）。多因素Cox回归分析显示ATP值是HCC复发的独立预测因子。结论免疫功能检测具有评估肝移植感染和排斥反应风险及预测肝细胞癌移植后肿瘤复发的潜力。
Purpose An immune function assay has been proposed as a new strategy to monitor immunosuppression after organ transplantation. However, there are limited data regarding its role in liver transplant recipients with hepatocellular carcinoma (HCC). In this study, we sought to determine the utility of this functional assay in assessing the risk of infection, rejection, and tumor recurrence in liver transplant recipients.Methods Immune function was determined by Immu-Know assay that measures the amount of adenosine triphosphate (ATP) produced by CD4 (+) T cells to monitor the global immune status in 342 whole blood samples from 105 liver transplant recipients. The association between ATP value and post-transplant tumor recurrence was evaluated in 60 HCC patients. The ATP value in predicting tumor recurrence in other independent cohort of 92 recipients with HCC was analyzed prospectively.Results The mean ATP values of liver transplant recipients with infection (145.2 +/- 87.0 ng/ml) or acute rejection (418.9 +/- 169.5 ng/ml) were different from those with stable state (286.6 +/- 143.9 ng/ml, P < 0.05). In recipients with HCC who developed recurrent tumors, the values were significantly lower than those without recurrence (137.8 +/- 66.4 vs. 289 +/- 133.9 ng/ml, P < 0.01); the optimal threshold value to predict post-transplant tumor recurrence was 175 ng/ml. Comparing with the patients in lower immune group (ATP 175 ng/ml) experienced significantly better disease-free survival (P < 0.01). Multivariate Cox regression analysis showed the ATP value was an independent predictor of HCC recurrence.Conclusions The immune function assay has the potential to assess the risk of infection and rejection in liver transplantation and to predict post-transplant tumor recurrence in recipients with HCC.