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P9.52 Role Of Circulating Tumour Cells In The Management Of The Liver Transplant Patient With Hepatocellular Carcinoma

Felipe Alconchel, Spain

Surgeon
Department of Surgery and Transplantation
Virgen de la Arrixaca University Hospital (IMIB-Arrixaca)

Abstract

Role of circulating tumour cells in the management of the liver transplant patient with hepatocellular carcinoma

Felipe Alconchel1,2, Francisco Villalba2, Luis Sáenz2,3, María Isabel Sánchez-Lorencio2, David Ferreras1,2, Pedro Antonio Cascales-Campos1,2, Beatriz Febrero1,2, Laura Martínez-Alarcón1,2, Marta Jover1,2, Francisco Sánchez-Bueno1,2, Ricardo Robles-Campos1,2, Pablo Ramírez1,2.

1Surgery and Organ Transplantation, Virgen de la Arrixaca University Hospital, Murcia, Spain; 2Biomedical Research Institute of Murcia (IMIB-Virgen de la Arrixaca), Murcia, Spain; 3Rafael Méndez Hospital, Lorca, Spain

Introduction: For hepatocellular carcinoma (HCC), liver transplantation (LT) is considered a curative treatment, however, more than 10% of transplant recipients have recurrences within the first year. This suggests the existence of circulating-tumor-cells (CTC) that spread from a primary tumor and travel to peripheral blood and distant organs. Their detection and monitoring could be of great clinical value to an early prediction of recurrence as a real-time liquid biopsy. The aim of this study is to determine the relationship between CTC and clinicopathological variables and to compare the CTC-levels in patients with HCC before transplantation and at one and two years after surgery.

Methods: Peripheral blood was obtained from 34 patients with HCC included in the LT list. Immunomagnetic isolation of CTC was performed by the IsoFlux® System. Cell enrichment was stained with anti-CK, Hoechst-33342 and antiCD45, performing cell counting under a fluorescence microscope. The clinicopathological variables (number of tumors, vascular invasion, tumor necrosis and recurrence) were collected. Spearman's rho, Mann-Whitney and Wilcoxon test were used.

Results: We found statistically significant differences in the CTC-levels between patients with vascular invasion and those without (U=0; p=0.005) such that patients with vascular invasion had median levels of 539 CTC/10 mL (IR: 448-1768) and those without vascular invasion had median levels of 3 CTC/10 mL (IR:0- 31.25). Also we found a statistically significant decrease in post-transplant CTC-values at one year (Z= -2.672/ p=0.008) and two years (Z= -2.218/ p=0.027).

Conclusions: The median CTC-levels of the patients included in the study showed a downward trend after liver transplantation. Also, a significant difference was found in the levels of pre-transplant-CTC between patients with and without vascular invasion, these levels being significantly higher in patients with vascular invasion compared to those without vascular invasion. Detection of CTC may have a useful clinical implication in predicting the evolution of HCC after LT.

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