Analysis of Circulating Tumor Cells in Patients with Hepatocellular Carcinoma Recurrence following Liver Transplantation

Abstract

Although studies have shown that detection of peripheral circulating tumor cells (CTCs) is an important tool for monitoring prognosis and therapeutic response in patients with cancer, few studies have analyzed their role in patients with hepatocellular carcinoma (HCC) following liver transplantation (LTx). The present study examined whether CTC levels were associated with HCC recurrence in patients with HCC after LTx. This prospective study included 47 patients who received LTx between October 2014 and May 2016 and who underwent analysis for peripheral CTCs at least twice using the CanPatrol system. Baseline Edmondson stage, T stage, accumulated tumor diameter, microvascular cancer embolus, and alpha-fetoprotein (AFP) levels were greater in patients with recurrence (all p<0.05). In addition, 70.2% of patients with HCC were CTC-positive. Although the proportion of CTC subtypes changes following LTx and over the follow-up period with increased epithelial and interstitial CTC levels, no significant associations were observed between change in total CTCs or CTC subtype and HCC recurrence (all p>0.05). In conclusion, baseline Edmondson stage, T stage, accumulated tumor diameter, microvascular cancer embolus, and AFP levels may be predictive of HCC recurrence following LTx; however, CTC levels and subtypes were not. Further large, multicenter studies are necessary to confirm these results.