IR@PKUHSC  > 北京大学第二临床医学院  > 肝胆外科
学科主题临床医学
Histological differentiation predicts post-liver transplantation survival time
Li, Wen Xia; Li, Zhao; Gao, Peng Ji; Gao, Jie; Zhu, Ji Ye
刊名CLINICS AND RESEARCH IN HEPATOLOGY AND GASTROENTEROLOGY
2014-04-01
DOI10.1016/j.clinre.2013.11.002
38期:2页:201-208
收录类别SCI
文章类型Article
WOS标题词Science & Technology
类目[WOS]Gastroenterology & Hepatology
研究领域[WOS]Gastroenterology & Hepatology
关键词[WOS]GAMMA-CARBOXY PROTHROMBIN ; HEPATOCELLULAR-CARCINOMA ; MILAN CRITERIA ; UP-TO-7 CRITERIA ; TUMOR SIZE ; RECURRENCE ; EXPERIENCE ; RESECTION ; CANCER ; IMPACT
英文摘要

Objectives: Although liver transplantation is the most effective long-term treatment for hepatocellular carcinoma (HCC), the recurrence of HCC remains an issue. Current research examining recurrence after liver transplantation primarily focuses on patients′ clinical characteristics. There is no consensus regarding the factors that may relate to predict the survival time and recurrence rates for patients with hepatitis B virus (HBV)-associated HCC transplantation using clinicopathological analysis.

Methods: One hundred and three patients with HCC were enrolled in the study. All data were collected from the China Liver Transplant Registry. The independent variables were as follows: age, gender, etiology, preoperative alpha-fetoprotein (AFP) levels, body mass index (BMI), Model for End-stage Liver Disease (MELD) and Child-Pugh scores, primary tumor, regional nodes, metastasis (TNM) classification, number of tumors, the size for the largest tumor, multifocality, portal vein tumor thrombosis and histological differentiation, and prognostic staging score criteria (Milan criteria). All of the patients had previously undergone liver transplantation. Univariate and multivariate analysis were used to determine the factors related to the survival time and recurrence.

Results: After a median follow-up period of 41.05 +/- 28.90 months, the 5-year overall survival rate was 46.60%, and the 5-year recurrence rate was 45.63%. Forty-seven patients (45.63%) died due to HCC recurrence during the follow-up period. Patients within Milan criteria exhibited excellent post-transplantation survival times. Univariate analysis suggested that patients with poor tumor differentiation, AFP >= 400 ng/ml, portal vein tumor thrombosis, and TNM staging of I + II had significantly predicted shorter survival times and higher recurrence than patients displaying good or moderate tumor differentiation, AFP < 400 ng/ml, no portal vein thrombosis and TNM staging of III + IV for HBV-associated HCC. However, multivariate analysis revealed that poor tumor differentiation and high serum AFP were associated with a shorter survival time. Moreover, poor tumor differentiation suggested high recurrence. In addition, patients′ survival time with AFP < 400 ng/ml was longer than that of patients with AFP >= 400 ng/ml even in patients with HCC beyond Milan criteria.

Conclusions: Tumor biological characteristics especially histological differentiation and serum AFP level should be considered before performing liver transplantation (LT) for patients with HBV-associated HCC. Furthermore, the AFP level and histological differentiation provide anew method for assessing HCC patient survival time after LT. Histological differentiation independently predicted post-transplantation survival time and recurrence rate for patients with HBV-associated HCC. (C) 2013 Elsevier Masson SAS. All rights reserved.

语种英语
WOS记录号WOS:000335442500019
引用统计
被引频次:6[WOS]   [WOS记录]     [WOS相关记录]
文献类型期刊论文
条目标识符http://ir.bjmu.edu.cn/handle/400002259/55175
专题北京大学第二临床医学院_肝胆外科
北京大学基础医学院
作者单位Peking Univ, Peoples Hosp, Dept Hepatobiliary Surg, Beijing 01088324175, Peoples R China
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Li, Wen Xia,Li, Zhao,Gao, Peng Ji,et al. Histological differentiation predicts post-liver transplantation survival time[J]. CLINICS AND RESEARCH IN HEPATOLOGY AND GASTROENTEROLOGY,2014,38(2):201-208.
APA Li, Wen Xia,Li, Zhao,Gao, Peng Ji,Gao, Jie,&Zhu, Ji Ye.(2014).Histological differentiation predicts post-liver transplantation survival time.CLINICS AND RESEARCH IN HEPATOLOGY AND GASTROENTEROLOGY,38(2),201-208.
MLA Li, Wen Xia,et al."Histological differentiation predicts post-liver transplantation survival time".CLINICS AND RESEARCH IN HEPATOLOGY AND GASTROENTEROLOGY 38.2(2014):201-208.
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