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Article: Post-transplant inflammatory cytokine signature adds value for predicting tumor recurrence after liver transplantation for hepatocellular carcinoma

TitlePost-transplant inflammatory cytokine signature adds value for predicting tumor recurrence after liver transplantation for hepatocellular carcinoma
Authors
KeywordsCytokines
Hepatocellular carcinoma
Inflammation
Liver transplantation
Post-LT surveillance
Tumor recurrence
Issue Date5-Aug-2023
PublisherSpringer
Citation
Hepatology International, 2023, v. Pending How to Cite?
Abstract

Background: Cytokines are key regulators of post-transplant inflammation responses which reconstitute post-transplant hepatic and systemic environments to influence the likelihood of tumor relapse. This study investigated the prognostic value of post-transplant cytokines on tumor recurrence after liver transplantation (LT) for hepatocellular carcinoma (HCC). Methods: A retrospective analysis was conducted in prospectively collected 150 adult HCC patients who received liver transplantation from 1997 to 2015. The post-transplant 41 inflammatory cytokines were quantified by multiplexing analysis and determined their prognostic value for predicting post-LT tumor recurrence by receiver operative characteristic analysis. A prediction model for post-LT tumor recurrence was generated by the logistic regression and internally validated Bootstrapping and compared with external prediction models. Results: Post-transplant circulating CCL11, IFNα2, and IL17A cytokines were identified to be significant predictors of post-LT tumor recurrence and survival. A prediction score composed of the post-transplant 3-cytokine (P3C) signature, UCSF criteria, and pre-LT AFP was established. The P3C-UCSF-AFP score significantly predicted post-LT tumor recurrence and poor survival both in deceased donor liver transplantation (DDLT) and living donor liver transplantation (LDLT). The P3C-UCSF-AFP score was validated to significantly predict post-LT 2-year and 5-year tumor recurrence, outperforming the RETREAT score, French AFP model, up-to-seven, UCSF criteria, and Milan criteria. Importantly, the P3C-UCSF-AFP score could cost-effectively stratify high-risk recipients subjected to a refinement of post-recurrence survival. Conclusion: The integrated P3C-UCSF-AFP score not only compensated for the pre-LT unpredictability and predicted post-LT tumor recurrence accurately, but also guided the clinical refinements of post-LT surveillance and therapeutic strategies in transplant oncology. Graphical abstract: [Figure not available: see fulltext.]


Persistent Identifierhttp://hdl.handle.net/10722/331218
ISSN
2023 Impact Factor: 5.9
2023 SCImago Journal Rankings: 1.813
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorNg, KT-
dc.contributor.authorLiu, J-
dc.contributor.authorYeung, OW-
dc.contributor.authorPang, L-
dc.contributor.authorShiu, HC-
dc.contributor.authorLiu, H-
dc.contributor.authorYang, XX-
dc.contributor.authorChan, AC-
dc.contributor.authorWong, TC-
dc.contributor.authorLo, CM-
dc.contributor.authorMan, K-
dc.date.accessioned2023-09-21T06:53:48Z-
dc.date.available2023-09-21T06:53:48Z-
dc.date.issued2023-08-05-
dc.identifier.citationHepatology International, 2023, v. Pending-
dc.identifier.issn1936-0533-
dc.identifier.urihttp://hdl.handle.net/10722/331218-
dc.description.abstract<p>Background: Cytokines are key regulators of post-transplant inflammation responses which reconstitute post-transplant hepatic and systemic environments to influence the likelihood of tumor relapse. This study investigated the prognostic value of post-transplant cytokines on tumor recurrence after liver transplantation (LT) for hepatocellular carcinoma (HCC). Methods: A retrospective analysis was conducted in prospectively collected 150 adult HCC patients who received liver transplantation from 1997 to 2015. The post-transplant 41 inflammatory cytokines were quantified by multiplexing analysis and determined their prognostic value for predicting post-LT tumor recurrence by receiver operative characteristic analysis. A prediction model for post-LT tumor recurrence was generated by the logistic regression and internally validated Bootstrapping and compared with external prediction models. Results: Post-transplant circulating CCL11, IFNα2, and IL17A cytokines were identified to be significant predictors of post-LT tumor recurrence and survival. A prediction score composed of the post-transplant 3-cytokine (P3C) signature, UCSF criteria, and pre-LT AFP was established. The P3C-UCSF-AFP score significantly predicted post-LT tumor recurrence and poor survival both in deceased donor liver transplantation (DDLT) and living donor liver transplantation (LDLT). The P3C-UCSF-AFP score was validated to significantly predict post-LT 2-year and 5-year tumor recurrence, outperforming the RETREAT score, French AFP model, up-to-seven, UCSF criteria, and Milan criteria. Importantly, the P3C-UCSF-AFP score could cost-effectively stratify high-risk recipients subjected to a refinement of post-recurrence survival. Conclusion: The integrated P3C-UCSF-AFP score not only compensated for the pre-LT unpredictability and predicted post-LT tumor recurrence accurately, but also guided the clinical refinements of post-LT surveillance and therapeutic strategies in transplant oncology. Graphical abstract: [Figure not available: see fulltext.]</p>-
dc.languageeng-
dc.publisherSpringer-
dc.relation.ispartofHepatology International-
dc.subjectCytokines-
dc.subjectHepatocellular carcinoma-
dc.subjectInflammation-
dc.subjectLiver transplantation-
dc.subjectPost-LT surveillance-
dc.subjectTumor recurrence-
dc.titlePost-transplant inflammatory cytokine signature adds value for predicting tumor recurrence after liver transplantation for hepatocellular carcinoma-
dc.typeArticle-
dc.identifier.doi10.1007/s12072-023-10566-1-
dc.identifier.scopuseid_2-s2.0-85166906853-
dc.identifier.volumePending-
dc.identifier.eissn1936-0541-
dc.identifier.isiWOS:001043354900001-
dc.identifier.issnl1936-0533-

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