Prediction of Posthepatectomy Recurrence of Hepatocellular Carcinoma by Circulating Cancer Stem Cells: A Prospective Study

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Titel: Prediction of Posthepatectomy Recurrence of Hepatocellular Carcinoma by Circulating Cancer Stem Cells: A Prospective Study
Autoren: Fan, ST, Wong, J, Ng, MNP, Yu, WC, Yang, ZF, Ho, DWY
Quelle: Annals of Surgery. 254:569-576
Verlagsinformationen: Ovid Technologies (Wolters Kluwer Health), 2011.
Publikationsjahr: 2011
Schlagwörter: Local - blood - epidemiology, Adult, Aged, 80 and over, Male, Carcinoma, Hepatocellular, Carcinoma, Liver Neoplasms, Carcinoma, Hepatocellular - blood - surgery, Hepatocellular - blood - surgery, Middle Aged, 3. Good health, 03 medical and health sciences, Neoplasm Recurrence, 0302 clinical medicine, Predictive Value of Tests, Neoplastic Stem Cells, Liver Neoplasms - blood - surgery, Hepatectomy, Humans, Female, Neoplasm Recurrence, Local - blood - epidemiology, Prospective Studies, Neoplasm Recurrence, Local, Aged
Beschreibung: To investigate whether circulating cancer stem cells (CSCs) of hepatocellular carcinoma (HCC) can predict its recurrence after hepatectomy.HCC recurrence frequently occurs within the first year after hepatectomy, probably due to circulating tumor cells that have been shed from the primary tumor before hepatectomy. Because CSCs are more likely to initiate tumor growth than mature cancer cells, a high level of circulating CSCs may be a hint for HCC recurrence.Multicolor flow cytometry was used to detect the number of circulating CSCs (CD45CD90CD44) in the peripheral circulation of 82 HCC patients 1 day before hepatectomy. The patients were monitored by CT or MRI for recurrence every 3 months.Forty-one (50%) patients had recurrence after a median follow-up period of 13.2 months (range, 1.3-57.1 months). Patients with recurrence had a higher median level of circulating CSCs than patients without recurrence (0.02% vs. 0.01%; P < 0.0001). Circulating CSCs > 0.01% predicted intrahepatic recurrence (relative risk 3.54; 95% CI, 1.41-8.88; P = 0.007) and extrahepatic recurrence (relative risk 10.15; 95% CI, 3-34.4; P = 0.0002). Patients with >0.01% circulating CSCs had a lower 2-year recurrence-free survival rate (22.7% vs. 64.2%; P < 0.0001) and overall survival rate (58.5% vs. 94.1%; P = 0.0005) than patients with ≤0.01% circulating CSCs. On multivariable analysis, circulating CSCs > 0.01%, tumor stage and tumor size were independent factors predicting recurrence-free survival.Circulating CSCs predicted posthepatectomy HCC recurrence with high accuracy. They may be the target of eradication in the prevention of posthepatectomy HCC metastasis and recurrence.
Publikationsart: Article
Sprache: English
ISSN: 0003-4932
DOI: 10.1097/sla.0b013e3182300a1d
Zugangs-URL: https://pubmed.ncbi.nlm.nih.gov/21892074
https://insights.ovid.com/crossref?an=00000658-201110000-00004
https://europepmc.org/article/MED/21892074
http://www.ncbi.nlm.nih.gov/pubmed/21892074
http://journals.lww.com/00000658-201110000-00004
http://hub.hku.hk/handle/10722/142543
http://hdl.handle.net/10722/142543
Dokumentencode: edsair.doi.dedup.....d0b78a4668fc5d9e5c01bde0c46b488d
Datenbank: OpenAIRE
Beschreibung
Abstract:To investigate whether circulating cancer stem cells (CSCs) of hepatocellular carcinoma (HCC) can predict its recurrence after hepatectomy.HCC recurrence frequently occurs within the first year after hepatectomy, probably due to circulating tumor cells that have been shed from the primary tumor before hepatectomy. Because CSCs are more likely to initiate tumor growth than mature cancer cells, a high level of circulating CSCs may be a hint for HCC recurrence.Multicolor flow cytometry was used to detect the number of circulating CSCs (CD45CD90CD44) in the peripheral circulation of 82 HCC patients 1 day before hepatectomy. The patients were monitored by CT or MRI for recurrence every 3 months.Forty-one (50%) patients had recurrence after a median follow-up period of 13.2 months (range, 1.3-57.1 months). Patients with recurrence had a higher median level of circulating CSCs than patients without recurrence (0.02% vs. 0.01%; P < 0.0001). Circulating CSCs > 0.01% predicted intrahepatic recurrence (relative risk 3.54; 95% CI, 1.41-8.88; P = 0.007) and extrahepatic recurrence (relative risk 10.15; 95% CI, 3-34.4; P = 0.0002). Patients with >0.01% circulating CSCs had a lower 2-year recurrence-free survival rate (22.7% vs. 64.2%; P < 0.0001) and overall survival rate (58.5% vs. 94.1%; P = 0.0005) than patients with ≤0.01% circulating CSCs. On multivariable analysis, circulating CSCs > 0.01%, tumor stage and tumor size were independent factors predicting recurrence-free survival.Circulating CSCs predicted posthepatectomy HCC recurrence with high accuracy. They may be the target of eradication in the prevention of posthepatectomy HCC metastasis and recurrence.
ISSN:00034932
DOI:10.1097/sla.0b013e3182300a1d