title: Association of preoperative EpCAM Circulating Tumor Cells and peripheral Treg cell levels with early recurrence of hepatocellular carcinoma following radical hepatic resection.
abstract: This study was carried out to determine the prognostic significance of preoperative peripheral epithelial cell adhesion molecule- positive (EpCAM (+)) circulating tumor cell (CTC) and T regulatory (Treg) cell levels in hepatocellular carcinoma (HCC) patients for the prediction of postoperative recurrence following curative resection.
  
  
  
  A total of 49 patients about to undergo curative resection for HCC were recruited into the study. PCR and FACS were used to detect the preoperative levels of EpCAM (mRNA+) CTCs and CD4(+)CD25(+)Foxp3(+) Treg cells. The prognostic value of EpCAM (mRNA+) CTCs, CD4(+)CD25(+)Foxp3(+) Treg cells, and other clinicopathological factors were analyzed by applying the Kaplan-Meier method and the multivariate Cox proportional hazards model.
  
  
  
  The number of EpCAM (mRNA+) CTCs and Treg/CD4(+) cells showed significant correlation as prognostic factors of postoperative HCC recurrence: EpCAM (mRNA+) CTC ≥ 2.22 (P = 0.001) and Treg/CD4(+) ≥ 5.07 (P = 0.045), with EpCAM (mRNA+) CTC ≥ 2.22 (P = 0.003, HR = 6.668) being the most important indicator. Patients with high CTC/Treg levels showed a significantly higher risk of developing postoperative HCC recurrence than those with low CTC/Treg levels (66.7 % vs. 10.3 %, P < 0.001). The high CTC/low Treg group also presented higher 1-year recurrence rates compared with the low CTC/low Treg level group (50.0 % vs. 10.3 %, P = 0.004).
  
  
  
  Elevated EpCAM (mRNA+) CTC and Treg/CD4(+) levels were associated with early recurrence of HCC, indicative of poor clinical outcome. The combined detection of EpCAM (mRNA+) CTC and Treg/CD4(+) may therefore provide a novel prognostic predictor for HCC patients.
authors.affiliation: Department of Laboratory Medicine, Zhongshan Hospital, Fudan University, 136 Yi Xue Yuan Road, Shanghai, 200032, People's Republic of China.
authors.forename: Yan
authors.initials: Y
authors.lastname: Zhou
authors.affiliation: Department of Laboratory Medicine, Zhongshan Hospital, Fudan University, 136 Yi Xue Yuan Road, Shanghai, 200032, People's Republic of China.
authors.forename: Beili
authors.initials: B
authors.lastname: Wang
authors.affiliation: Department of Laboratory Medicine, Zhongshan Hospital, Fudan University, 136 Yi Xue Yuan Road, Shanghai, 200032, People's Republic of China.
authors.forename: Jiong
authors.initials: J
authors.lastname: Wu
authors.affiliation: Department of Laboratory Medicine, Zhongshan Hospital, Fudan University, 136 Yi Xue Yuan Road, Shanghai, 200032, People's Republic of China.
authors.forename: Chunyan
authors.initials: C
authors.lastname: Zhang
authors.affiliation: Department of Laboratory Medicine, Zhongshan Hospital, Fudan University, 136 Yi Xue Yuan Road, Shanghai, 200032, People's Republic of China.
authors.forename: Yiwen
authors.initials: Y
authors.lastname: Zhou
authors.affiliation: Liver Cancer Institute, Fudan University, 136 Yi Xue Yuan Road, Shanghai, 200032, People's Republic of China.
authors.forename: XinRong
authors.initials: X
authors.lastname: Yang
authors.affiliation: Liver Cancer Institute, Fudan University, 136 Yi Xue Yuan Road, Shanghai, 200032, People's Republic of China.
authors.forename: Jian
authors.initials: J
authors.lastname: Zhou
authors.affiliation: Department of Laboratory Medicine, Zhongshan Hospital, Fudan University, 136 Yi Xue Yuan Road, Shanghai, 200032, People's Republic of China. guo.wei@zs-hospital.sh.cn.
authors.forename: Wei
authors.initials: W
authors.lastname: Guo
authors.affiliation: Liver Cancer Institute, Fudan University, 136 Yi Xue Yuan Road, Shanghai, 200032, People's Republic of China. fan.jia@zs-hospital.sh.cn.
authors.forename: Jia
authors.initials: J
authors.lastname: Fan
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006528:Carcinoma, Hepatocellular / Q000235:genetics / Q000473:pathology / Q000601:surgery*; D000071858:Epithelial Cell Adhesion Molecule / Q000097:blood / Q000235:genetics*; D005260:Female; D015972:Gene Expression Regulation, Neoplastic; D006801:Humans; D053208:Kaplan-Meier Estimate; D008099:Liver / Q000378:metabolism / Q000473:pathology / Q000601:surgery; D008113:Liver Neoplasms / Q000235:genetics / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009364:Neoplasm Recurrence, Local; D009360:Neoplastic Cells, Circulating / Q000378:metabolism*; D017063:Outcome Assessment, Health Care / Q000379:methods / Q000706:statistics & numerical data; D057234:Preoperative Period; D011379:Prognosis; D016016:Proportional Hazards Models; D020133:Reverse Transcriptase Polymerase Chain Reaction; D050378:T-Lymphocytes, Regulatory / Q000378:metabolism*; D013997:Time Factors
chemical_list: D000071858:Epithelial Cell Adhesion Molecule
keywords: Circulating tumor cells; Epithelial cell adhesion molecule; Hepatocellular carcinoma; Regulatory T cells; Tumor recurrence