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Serum biomarkers and risk of hepatocellular carcinoma recurrence after liver transplantation

World Journal of Hepatology 2019年第1期11卷 50-63页

作者： Maria J Citores Jose L Lucena Sara de la Fuente valentin cuervas-mons Department of Internal Medicine Instituto de Investigación Sanitaria Puerta de Hierro-Segovia de Arana Liver Transplantation Unit Hospital Universitario Puerta de Hierro-Majadahonda Department of Surgery Hospital Universitario Puerta de Hierro-Majadahonda valentin cuervas-mons Department of Internal Medicine HospitalUniversitario Puerta de Hierro-Majadahonda Department of Medicine Universidad Autónoma de Madrid

Liver transplantation(LT) is the only potentially curative treatment for selected patients with cirrhosis and hepatocellular carcinoma(HCC) who are not candidates for resection. When the Milan criteria are strictly applied, 75% to85%of 3-to 4-year actuarial survival rates are achieved, but up to 20% of the patients experience HCC recurrence after transplantation. The Milan criteria are based on the preoperative tumor macromorphology, tumor size and number on computed tomography or magnetic resonance imaging that neither correlate well with posttransplant histological study of the liver explant nor accurately predict HCC recurrence after LT, since they do not include objective measures of tumor biology. Preoperative biological markers, including alpha-fetoprotein, desgamma-carboxiprothrombin or neutrophil-to-lymphocyte ratio and platelet-tolymphocyte ratio, can predict the risk for HCC recurrence after transplantation.These biomarkers have been proposed as surrogate markers of tumor differentiation and vascular invasion, with varied risk magnitudes depending on the defined cutoffs. Different studies have shown that the combination of one or several biomarkers integrated into prognostic models predict the risk of HCC recurrence after LT more accurately than Milan criteria alone. In this review, we focus on the potential utility of these serum biological markers to improve the performance of Milan criteria to identify patients at high risk of tumoral Published online: January 27, 2019 recurrence after LT.Liver transplantation(LT) is the only potentially curative treatment for selected patients with cirrhosis and hepatocellular carcinoma(HCC) who are not candidates for resection. When the Milan criteria are strictly applied, 75% to85%of 3-to 4-year actuarial survival rates are achieved, but up to 20% of the patients experience HCC recurrence after transplantation. The Milan criteria are based on the preoperative tumor macromorphology, tumor size and number on computed tomography or magnetic resonance imaging that nei

关键词： Hepatocellular carcinoma Liver transplantation Recurrence Selection criteria Prognostic score Biomarker Alpha-fetoprotein Systemic inflammatory marker

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