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Analysis of circulating tumor cells in patients with hepatocellular carcinoma recurrence following liver transplantation
  1. Shaoping Wang1,2,
  2. Yujian Zheng1,
  3. Jun Liu1,
  4. Feng Huo1,
  5. Jie Zhou2
  1. 1Centre of Liver Transplantation, Guangzhou General Hospital of Chinese PLA, Guangzhou, China
  2. 2Department of Hepatobiliary Surgery, Nan-Fang Hospital, Southern Medical University, Guangzhou, China
  1. Correspondence to Dr Jie Zhou, Department of Hepatobiliary Surgery, Nan-Fang Hospital, Southern Medical University, Guangzhou 510010, China; zhoujiezj{at}


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.

  • liver
  • liver diseases
  • recurrence
  • cancer

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  • Contributors SW: study concept, study design, definition of intellectual content, clinical studies, experimental studies, data analysis, statistical analysis, manuscript preparation. YZ: clinical studies, experimental studies. JL: literature research, data acquisition. FH: manuscript editing, manuscript review. JZ: guarantor of integrity of the entire study, manuscript review. All authors have read and approved the final version to be submitted.

  • Funding This work was supported by funding from Guangdong Department of Science and Technology.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Ethics approval This study was approved by the Institutional Review Board of the Guangzhou General Hospital (approval number: ChiCTR-OCN-15006949).

  • Provenance and peer review Not commissioned; externally peer reviewed.

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