Peritransplant Lymphopenia Is a Novel Prognostic Factor in Recurrence of Hepatocellular Carcinoma After Liver Transplantation
Peritransplant Lymphopenia Is a Novel Prognostic Factor in Recurrence of Hepatocellular Carcinoma After Liver Transplantation
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DOI：
10.1097/01.tp.0000437426.15890.1d
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发表时间：
2014-03-27
期刊：
影响因子：
6.2
通讯作者：
Yoshida, Atsushi
中科院分区：
文献类型：
--
作者：
Nagai, Shunji;Abouljoud, Marwan S.;Yoshida, Atsushi
淋巴细胞绝对计数（ALC）被认为是患者免疫抑制水平和营养状况的替代标志物，也是几种癌症生存和复发的预后因素。本研究的目的是探讨肝移植术后肝细胞癌（HCC）复发的预后价值。方法对2000年至2010年接受LT的HCC患者进行评估。排除标准为肝细胞癌和胆管细胞癌。肝移植前、肝移植后2周和1个月的肝移植物周围ALCs与肿瘤、手术和供体特征一起进行沿着分析，以确定HCC复发的危险因素。结果173例肝移植患者中有27例（15.6%）发生HCC。中位复发时间为1.14年。LT前后的低ALC与持续的较高复发率相关（LT前：风险比=1.12，P=0.003; LT后2周：风险比=1.14，P=0.008; LT后1个月：风险比=1.06，P=0.055）（每降低100/L风险增加）。多变量考克斯回归分析显示，移植物周围持续性淋巴细胞减少症（
Background Absolute lymphocyte count (ALC) is considered a surrogate marker for the level of immunosuppression and nutritional status of patients and a prognostic factor for survival and recurrence in several cancers. The aim of this study was to investigate the prognostic value of peritransplant ALC for the recurrence of hepatocellular carcinoma (HCC) after liver transplantation (LT).Methods HCC patients who underwent LT between 2000 and 2010 were evaluated. Exclusion criteria were combined HCC and cholangiocarcinoma. Peritransplant ALCs (before LT and 2 weeks and 1 month after LT) were analyzed along with tumor, operative, and donor characteristics to identify risk factors for the recurrence of HCC.Results HCC developed in 27 of the 173 LT patients investigated for risk factors (15.6%). The median time to recurrence was 1.14 years. Low ALCs before and after LT were associated with a higher recurrence rate in a continuous manner (before LT: hazard ratio=1.12, P=0.003; 2 weeks after LT: hazard ratio=1.14, P=0.008; 1 month after LT: hazard ratio=1.06, P=0.055) (increased risk per 100/L down). On multivariate Cox regression analysis, peritransplant persistent lymphopenia (