title: Clonal Origin of Hepatocellular Carcinoma and Recurrence After Liver Transplantation.
abstract: BACKGROUND This study aimed to determine whether patterns of tumor clonal origin in pluri-nodular hepatocellular carcinoma (PNHC) could serve as an indicator of tumor recurrence following liver transplantation. MATERIAL AND METHODS Tumor tissue samples from 60 PNHC patients who underwent liver transplantation were examined. The diagnosis of patients conformed to the University of California San Francisco (UCSF) standards for pluri-nodular hepatocellular carcinoma. We performed loss of heterozygosity tests at multiple microsatellite sites to determine the clonal origins of the tumors. Clinical information, pathological data, preoperative serum alpha-feto protein (AFP) and postoperative follow-ups were obtained and correlations between the clonal origin of the tumor, tumor-free survival, pathological characteristics, and AFP levels in serum were studied. RESULTS A total of 165 tumor nodules were collected. Tumor clonal origins were identified as intrahepatic metastasis (IM; 41.67%), multicentric occurrence (MO; 55%) or unidentified (3.33%). Three-year tumor-free survival for the IM group was 48% compared to 75.76% in the MO group (p<0.05), while the occurrence of microscopic tumor thrombus was 100% and 3.03% (p<0.05) for these groups, respectively. The degree of tumor differentiation was 80% for the IM group and 18.18% for the MO group (p<0.05), while the mean AFP concentration for these groups was 226.80 μg/L (2.78-3000 μg/L) and 24.59 μg/L (1.16-531. 30 μg/L; p<0.05), respectively. CONCLUSIONS Clonal origin patterns can serve as important indicators to predict the recurrence of PNHC following liver transplantation. Taken together with pathological characteristics and preoperative serum AFP levels, the risk of recurrence can be established in advance.
authors.affiliation: Orient Organ Transplant Center, Tianjin First Center Hospital, Tianjin, China (mainland).
authors.forename: Zhenglu
authors.initials: Z
authors.lastname: Wang
authors.affiliation: Department of Surgery, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang, China (mainland).
authors.forename: Weihua
authors.initials: W
authors.lastname: Gong
authors.affiliation: Department of Surgery, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China (mainland).
authors.forename: Dawei
authors.initials: D
authors.lastname: Shou
authors.affiliation: , People's Hospital of Zhucheng City, Zhucheng, Shandong, China (mainland).
authors.forename: Luzhou
authors.initials: L
authors.lastname: Zhang
authors.affiliation: , First Central Clinical Institute of Tianjin Medical University, Tianjin, China (mainland).
authors.forename: Xiangqian
authors.initials: X
authors.lastname: Gu
authors.affiliation: Orient Organ Transplant Center, Tianjin First Center Hospital, Tianjin, China (mainland).
authors.forename: Yuliang
authors.initials: Y
authors.lastname: Wang
authors.affiliation: Orient Organ Transplant Center, Tianjin First Center Hospital, Tianjin, China (mainland).
authors.forename: Dahong
authors.initials: D
authors.lastname: Teng
authors.affiliation: Orient Organ Transplant Center, Tianjin First Center Hospital, Tianjin, China (mainland).
authors.forename: Hong
authors.initials: H
authors.lastname: Zheng
mesh_terms: D000328:Adult; D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000209:etiology* / Q000235:genetics / Q000601:surgery*; D002999:Clone Cells / Q000473:pathology; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000209:etiology* / Q000235:genetics / Q000601:surgery*; D016031:Liver Transplantation / Q000009:adverse effects*; D019656:Loss of Heterozygosity; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000209:etiology* / Q000235:genetics / Q000473:pathology; D014411:Neoplastic Stem Cells / Q000473:pathology; D012307:Risk Factors; D000509:alpha-Fetoproteins / Q000378:metabolism
chemical_list: C097353:AFP protein, human; D000509:alpha-Fetoproteins