Predictive value of biological markers for hepatocellular carcinoma patients treated with orthotopic liver transplantation.
OBJECTIVE
To help stratify candidates with hepatocellular carcinoma (HCC) for orthotopic liver transplantation (OLT), biomarkers are needed that are capable of predicting recurrence of disease (ROD). We investigated the prognostic role in this setting of immunohistochemical markers reported previously to predict poor prognosis in HCC patients treated with resection.


METHODS
Eighty-three patients with HCC who underwent OLT between 1987 and 2001 with a minimum clinical follow up of 12 months were included in this retrospective study. We analyzed immunohistochemical expression of the adhesion molecules E-cadherin and beta-catenin (membrane/nuclear localization), MIB-1 proliferative index and the cyclin-dependent kinase inhibitor p27, alongside the main clinical-pathological variables.


RESULTS
At univariate analysis, vascular thrombosis, high MIB-1 index, lower membrane expression of E-cadherin and beta-catenin, and nuclear beta-catenin localization were associated with ROD. At multivariate analysis, only MIB-1 index, low equal E-cadherin (with respect to non-neoplastic surrounding tissue), and nuclear beta-catenin appeared as independent predictors of ROD. The logistic regression analysis model indicated that detection of any one parameter was associated with at least 88% estimated risk of ROD (up to 99% for all three).


CONCLUSIONS
We propose these three molecular parameters as an additional tool for rational selection of OLT candidates among HCC patients (stratification according to the risk of ROD might help provide a similar life expectancy for cirrhotic candidates with and without HCC).
Fiorentino
Michelangelo
M
Pathology Unit of the "F. Addarii" Institute of Oncology, Department of Oncology and Hematology, Hopital Edouard Herriot, Lyon, France.
Altimari
Annalisa
A
Ravaioli
Matteo
M
Gruppioni
Elisa
E
Gabusi
Elena
E
Corti
Barbara
B
Vivarelli
Marco
M
Bringuier
Pierre-Paul
PP
Scoazec
Jean-Yves
JY
Grigioni
Walter Franco
WF
D'Errico-Grigioni
Antonia
A
D000328:Adult; D014408:Biomarkers, Tumor / Q000032:analysis*; D006528:Carcinoma, Hepatocellular / Q000401:mortality / Q000473:pathology* / Q000601:surgery*; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000401:mortality / Q000473:pathology* / Q000601:surgery*; D016031:Liver Transplantation / Q000401:mortality; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D011237:Predictive Value of Tests; D012008:Recurrence; D016019:Survival Analysis; D013997:Time Factors
D014408:Biomarkers, Tumor