title: Oncological Evaluation by Positron-emission Tomography, Circulating Tumor Cells and Alpha Fetoprotein in Patients With Hepatocellular Carcinoma on the Waiting List for Liver Transplantation.
abstract: BACKGROUND
  The objectives of this study are the determination of the number of circulating tumor cells (CTCs), by means of the IsoFlux enrichment system (Fluxion Biosciences Inc, San Francisco, California, United States) in patients with hepatocellular carcinoma (HCC) in compliance with the Milan criteria and on the waiting list for hepatic transplantation, as well as the study of its relation with the of α-fetoprotein levels (AFP) and positron-emission tomography-computed tomography (PET-CT) findings.
  
  
  METHODS
  An oncologycal evaluation with PET-CT, CTCs, and AFP was conducted in 24 consecutive patients with HCC eligible for orthotopic liver transplantation according to the Milan criteria. The diagnosis of HCC was made according to clinical, biological, and radiological findings.
  
  
  RESULTS
  We detected CTCs in peripheral blood in 21 of 24 patients (87.5%) before liver transplantation, with a mean number CTCs of 156 ± 370 (range, 2 to 1768) with statistically significant association between number of CTCs detected in peripheral blood and the time within the waiting list (P < .05), but not betwen AFP levels and standard uptake value and time to orthotopic liver transplantation (P > .05).
  
  
  CONCLUSIONS
  PET-TC, CTCs, and AFP levels could be an essential key for the correct management of the patients with HCC on the waiting list for liver transplantation.
authors.affiliation: Liver Transplant Unit, Department of Surgery, Clinical University Hospital Virgen de la Arrixaca-IMIB, Murcia, Spain.
authors.forename: P
authors.initials: P
authors.lastname: Ramirez
authors.affiliation: Clinical Analysis Department, Navarre Hospital Complex, Pamplona, Spain.
authors.forename: L
authors.initials: L
authors.lastname: Sáenz
authors.affiliation: Liver Transplant Unit, Department of Surgery, Clinical University Hospital Virgen de la Arrixaca-IMIB, Murcia, Spain. Electronic address: cascalex@yahoo.es.
authors.forename: P A
authors.initials: PA
authors.lastname: Cascales-Campos
authors.affiliation: Liver Transplant Unit, Department of Surgery, Clinical University Hospital Virgen de la Arrixaca-IMIB, Murcia, Spain.
authors.forename: M R
authors.initials: MR
authors.lastname: González Sánchez
authors.affiliation: Liver Transplant Unit, Department of Surgery, Clinical University Hospital Virgen de la Arrixaca-IMIB, Murcia, Spain.
authors.forename: E
authors.initials: E
authors.lastname: Llàcer-Millán
authors.affiliation: Clinical Analysis Department, Clinical University Hospital Virgen de la Arrixaca-IMIB, Murcia, Spain.
authors.forename: M I
authors.initials: MI
authors.lastname: Sánchez-Lorencio
authors.affiliation: Medical Oncology Department, Clinical Hospital San Carlos, Madrid, Spain.
authors.forename: E
authors.initials: E
authors.lastname: Díaz-Rubio
authors.affiliation: CTC Unit, Medical Oncology Department, Clinical Hospital San Carlos, Madrid, Spain.
authors.forename: V
authors.initials: V
authors.lastname: De La Orden
authors.affiliation: CTC Unit, Medical Oncology Department, Clinical Hospital San Carlos, Madrid, Spain.
authors.forename: B
authors.initials: B
authors.lastname: Mediero-Valeros
authors.affiliation: Department of Nuclear Medicine, Clinical University Hospital Virgen de la Arrixaca-IMIB, Murcia, Spain.
authors.forename: J L
authors.initials: JL
authors.lastname: Navarro
authors.affiliation: Biomedical Research Institute of Murcia (IMIB-Arrixaca-UMU), University Clinical Hospital "Virgen de la Arrixaca", University of Murcia, Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Murcia, Spain.
authors.forename: B
authors.initials: B
authors.lastname: Revilla Nuin
authors.affiliation: Biomedical Research Institute of Murcia (IMIB-Arrixaca-UMU), University Clinical Hospital "Virgen de la Arrixaca", University of Murcia, Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Murcia, Spain.
authors.forename: A
authors.initials: A
authors.lastname: Baroja-Mazo
authors.affiliation: Clinical Analysis Department, Clinical University Hospital Virgen de la Arrixaca-IMIB, Murcia, Spain.
authors.forename: J A
authors.initials: JA
authors.lastname: Noguera-Velasco
authors.affiliation: Liver Transplant Unit, Department of Surgery, Clinical University Hospital Virgen de la Arrixaca-IMIB, Murcia, Spain.
authors.forename: B F
authors.initials: BF
authors.lastname: Sánchez
authors.affiliation: Department of Pathology, Clinical University Hospital Virgen de la Arrixaca-IMIB, Murcia, Spain.
authors.forename: J
authors.initials: J
authors.lastname: de la Peña
authors.affiliation: Department of Hepatology, Clinical University Hospital Virgen de la Arrixaca-IMIB, Murcia, Spain.
authors.forename: J A
authors.initials: JA
authors.lastname: Pons-Miñano
authors.affiliation: Liver Transplant Unit, Department of Surgery, Clinical University Hospital Virgen de la Arrixaca-IMIB, Murcia, Spain.
authors.forename: F
authors.initials: F
authors.lastname: Sánchez-Bueno
authors.affiliation: Liver Transplant Unit, Department of Surgery, Clinical University Hospital Virgen de la Arrixaca-IMIB, Murcia, Spain.
authors.forename: R
authors.initials: R
authors.lastname: Robles-Campos
authors.affiliation: Liver Transplant Unit, Department of Surgery, Clinical University Hospital Virgen de la Arrixaca-IMIB, Murcia, Spain.
authors.forename: P
authors.initials: P
authors.lastname: Parrilla
mesh_terms: D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000097:blood* / Q000000981:diagnostic imaging; D002452:Cell Count; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000097:blood* / Q000000981:diagnostic imaging; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D009360:Neoplastic Cells, Circulating / Q000378:metabolism*; D000072078:Positron Emission Tomography Computed Tomography; D057234:Preoperative Period; D014850:Waiting Lists; D000509:alpha-Fetoproteins / Q000032:analysis*
chemical_list: D000509:alpha-Fetoproteins