Risk factors for hepatocellular carcinoma in hepatitis B cirrhosis patients given treatment with human umbilical cord mesenchymal stem cells / 中国组织工程研究

ABSTRACT

BACKGROUND: With the continuous development of mesenchymal stem cell therapy, it has been reported that stem cell therapy is likely to cause the occurrence and development of tumors. OBJECTIVE: To investigate the potential risks of hepatocellular carcinoma (HCC) in patients with hepatitis B cirrhosis after receiving human umbilical cord mesenchymal stem cells (hUC-MSCs) transplantation. METHODS: The study collected the information of patients with hepatitis B cirrhosis treated with hUC-MSCs, admitted at the Infectious Disease Department of the 105thHospital of PLA from January 2011 to December 2013. The following investigation lasted 36 months. The follow-up was terminated at the time of diagnostic confirmation. The risk factors that may affect the occurrence of HCC were analyzed by univariate Logistic and multivariate unconditional Logistic regression analyses. RESULTS AND CONCLUSION: (1) A total of 386 patients were followed up, including 171 patients who received hUC-MSCs transplantation as the observation group and 215 patients only given general internal medicine treatment as the control group. (2) At the follow-up of 12 months, the incidence of HCC in the observation group was significantly higher than that in the control group (P < 0.05). At the follow-up of 36 months, the incidence of HCC was 11.7% in the observation group and 9.8% in the control group (P > 0.05). (3) Univariate Logistic regression analysis showed that the HCC patients had higher age, alpha-fetoprotein (AFP), alpha-fetoprotein variants (AFP-L3), AFP-L3 ratio (AFP-L3%), and Golgi glycoprotein 73 (GP73) than those with no HCC in both control and observation groups (P < 0.05). Multivariate unconditional Logistic regression analysis showed that only APF-L3% was an independent risk factor for HCC in patients with hepatitis B cirrhosis undergoing hUC-MSCs transplantation. Overall, hUC-MSCs transplantation does not increase the HCC incidence in patients with hepatitis B cirrhosis within 3 years, but it may lead to an early onset of HCC. AFP-L3% can be used as an early predictor of HCC in patients with hepatitis B cirrhosis undergoing hUC-MSCs transplantation.