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Objective@#To explore the characteristics of tumor recurrence after liver transplantation in patients with hepatocellular carcinoma (HCC) associated with hepatitis B and to analyze the risk factors that influence the recurrence and prognosis.@*Methods@#The clinicopathological and survival data of 162 patients with hepatitis B –associated liver cancer who underwent liver transplantation in Peking University People’s Hospital from January 2002 to December 2016 were retrospectively analyzed. The postoperative survival rate (OS) and tumor free survival rate (DFS) was statistically analyzed by using the log-rank test. Univariate analysis was performed for various clinicopathological indicators, and the Cox proportional risk regression model was used for multivariate analysis.@*Results@#Univariate analysis showed that the age of the recipients (POS = 0.047, PDFS = 0.045), the maximum tumor size (P < 0.001, PDFS < 0.001), preoperative AFP levels (POS < 0.001, PDFS < 0.001), preoperative HBV-DNA levels (POS = 0.035, PDFS = 0.029), vein tumor thrombosis (POS < 0.001, PDFS < 0.001), and tumor differentiation degree (POS <0.001, PDFS < 0.001) were associated with overall prognosis and tumor recurrence. Multivariate analysis revealed that preoperative AFP levels (POS = 0.014, PDFS = 0.013), the maximum tumor size (POS < 0.001, PDFS = 0.001), vein tumor thrombosis (POS = 0.012, PDFS < 0.004), and tumor differentiation degree (POS = 0.004, PDFS = 0.009) were independent risk factors affecting overall prognosis and tumor recurrence.@*Conclusion@#The major prognostic factors linked to tumor biological characteristics after liver transplantation in HBV-related HCC patients are preoperative AFP levels, the largest tumor size, and vein tumor thrombosis and tumor differentiation degree.
Résumé
Objective To investigate the expression of EpCAM (epithelial cell adhesion molecule) in patients undergoing liver transplantation for hepatocellular carcinoma (HCC),and to explore the relationship between EpCAM expression level and HCC recurrence.Methods 83 HCC tissue samples were collected and analyzed retrospectively.EpCAM was detected by immunohistochemistry staining and the correlation between EpCAM and clinicopathological features,prognosis and recurrence were analyzed retrospectively from patients undergoing liver transplantation in Peking University People's Hospital from 2000 to 2010.Results Log-rank univariate survival analysis showed that the 5-year overall survival (41.2％ vs.73.3％,x2 =4.935,P =0.026) and 5-year disease free survival (41.2％ vs.73.3％,x2 =4.634,P =0.031)of HCC patients with high EpCAM expression level was significantly lower than that with low expression level of EpCAM.COX multivariate survival analysis showed patients with high EpCAM expression had a higher risk of recurrence(HR =2.860,95％ CI:1.012-8.083) and death (HR =2.909,95％ CI:1.030-8.217)after liver transplantation than those with low EpCAM expression,which was an independent predictor of 5-year overall survival and 5-year disease free survival recurrence (P =0.044).Furthermore,EpCAM expression level was highly related to tumor distant metastasis (P =0.01).Conclusion There was positive relation between high expression of EpCAM and high HCC recurrence after liver transplantation,suggesting that EpCAM can be a predictor for HCC recurrence and long-term survival of patients with HCC after transplantation.
Résumé
Hepatocellular carcinoma (HCC) is still one of common malignant cancers worldwide, with increasing incidence and mortality rates. Early diagnosis and effective treatment for HCC remain to be explored. This article introduces the research advances in the early specific diagnosis and effective therapies for HCC in 2016, such as molecular markers in the specific diagnosis and targeted therapy for HCC, main therapeutic regimens, robot-assisted liver resection, and no-touch radiofrequency ablation.