Circulating tumor cells are associated with poor outcomes in early-stage hepatocellular carcinoma: a prospective study
Background Previous studies evaluating association between circulating tumor cells (CTCs) and clinical outcomes in hepatocellular carcinoma (HCC) have shown inconsistent results due to suboptimal detection methods and patient heterogeneity. Methods Patients undergoing surgery for early-stage HCC wer...
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| Veröffentlicht in: | Hepatology international 2019-11, Vol.13 (6), p.726-735 |
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| creator | Ha, Yeonjung Kim, Tae Hun Shim, Jae Eul Yoon, Sunghyun Jun, Mi Jung Cho, Young-Ho Lee, Han Chu |
| description | Background
Previous studies evaluating association between circulating tumor cells (CTCs) and clinical outcomes in hepatocellular carcinoma (HCC) have shown inconsistent results due to suboptimal detection methods and patient heterogeneity.
Methods
Patients undergoing surgery for early-stage HCC were prospectively enrolled. The CTC numbers were determined using a tapered slit platform, which detects CTCs based on the cell size and morphology. Survival and recurrence were evaluated, and Cox proportional hazards models were used to demonstrate the prognostic significance of CTC.
Results
Of 105 patients, 25 had increased CTC numbers after surgery (ΔCTC > 0, defined as positive) and a significantly higher level of recurrence (
p
= 0.042). A positive ΔCTC was seen to be an independent predictor of recurrence (hazard ratio 2.28), along with hepatitis B virus infection, alanine aminotransferase level, and the presence of satellite nodules (all
p
|
| doi_str_mv | 10.1007/s12072-019-09994-9 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2312550194</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2312550194</sourcerecordid><originalsourceid>FETCH-LOGICAL-c375t-7dadcbcd27da9a384b61facea8fe7b487e76905f1b2ea3e349e66d8c6d5ae8ad3</originalsourceid><addsrcrecordid>eNp9kUtv3CAUhVHUKu8_kEWF1E03bsEYbLKrRm1TKVI37Rpdw_WEyDYu4ETz78t08pC66Ior3e8cDhxCrjj7yBlrPyVes7auGNcV01o3lT4ip1wLVTHZ8DcvsxAn5Cyle8akVFwdkxPBleasFafkYeOjXUfIft7SvE4hUovjmChEpJBSsB4yOvro8x1dQlmHNdswYaJ-pghx3FUpwxbpHS6Qw15c7IoLROvnMME1BbrEkBa02T8gTXl1uwvydoAx4eXTeU5-ff3yc3NT3f749n3z-bayopW5ah0421tXl0GD6Jpe8QEsQjdg2zddi63STA68rxEEikajUq6zyknADpw4Jx8OviXB7xVTNpNP-4wwY1iTqQWvpSw_2BT0_T_ofVjjXNLtKSkb1TFWqPpA2fKkFHEwS_QTxJ3hzOxbMYdWTPE0f1sxuojePVmv_YTuRfJcQwHEAUhlNW8xvt79H9s_9yWbMw</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2315546800</pqid></control><display><type>article</type><title>Circulating tumor cells are associated with poor outcomes in early-stage hepatocellular carcinoma: a prospective study</title><source>MEDLINE</source><source>SpringerNature Journals</source><creator>Ha, Yeonjung ; Kim, Tae Hun ; Shim, Jae Eul ; Yoon, Sunghyun ; Jun, Mi Jung ; Cho, Young-Ho ; Lee, Han Chu</creator><creatorcontrib>Ha, Yeonjung ; Kim, Tae Hun ; Shim, Jae Eul ; Yoon, Sunghyun ; Jun, Mi Jung ; Cho, Young-Ho ; Lee, Han Chu</creatorcontrib><description>Background
Previous studies evaluating association between circulating tumor cells (CTCs) and clinical outcomes in hepatocellular carcinoma (HCC) have shown inconsistent results due to suboptimal detection methods and patient heterogeneity.
Methods
Patients undergoing surgery for early-stage HCC were prospectively enrolled. The CTC numbers were determined using a tapered slit platform, which detects CTCs based on the cell size and morphology. Survival and recurrence were evaluated, and Cox proportional hazards models were used to demonstrate the prognostic significance of CTC.
Results
Of 105 patients, 25 had increased CTC numbers after surgery (ΔCTC > 0, defined as positive) and a significantly higher level of recurrence (
p
= 0.042). A positive ΔCTC was seen to be an independent predictor of recurrence (hazard ratio 2.28), along with hepatitis B virus infection, alanine aminotransferase level, and the presence of satellite nodules (all
p
< 0.05). Subgroup analyses showed that a positive ΔCTC was associated with lower survival and higher recurrence among patients with low alpha-fetoprotein levels and cirrhosis (all
p
< 0.05).
Conclusion
Calculation of ΔCTC based on the physical properties of the cells is predictive of recurrence in patients with early HCC undergoing surgery.</description><identifier>ISSN: 1936-0533</identifier><identifier>EISSN: 1936-0541</identifier><identifier>DOI: 10.1007/s12072-019-09994-9</identifier><identifier>PMID: 31691073</identifier><language>eng</language><publisher>New Delhi: Springer India</publisher><subject>Alanine ; Alanine transaminase ; Biomarkers, Tumor - blood ; Carcinoma, Hepatocellular - blood ; Carcinoma, Hepatocellular - mortality ; Carcinoma, Hepatocellular - pathology ; Carcinoma, Hepatocellular - surgery ; Cell size ; Cell survival ; Cirrhosis ; Colorectal Surgery ; Cytology ; Female ; Health hazards ; Health risk assessment ; Hepatitis ; Hepatitis B ; Hepatocellular carcinoma ; Hepatology ; Heterogeneity ; Humans ; Liver cancer ; Liver cirrhosis ; Liver Neoplasms - blood ; Liver Neoplasms - mortality ; Liver Neoplasms - pathology ; Liver Neoplasms - surgery ; Male ; Medicine ; Medicine & Public Health ; Middle Aged ; Morphology ; Neoplasm Recurrence, Local - blood ; Neoplasm Recurrence, Local - mortality ; Neoplasm Recurrence, Local - pathology ; Neoplasm Recurrence, Local - surgery ; Neoplasm Staging ; Neoplastic Cells, Circulating ; Nodules ; Original Article ; Patients ; Physical properties ; Predictive Value of Tests ; Prognosis ; Proportional Hazards Models ; Prospective Studies ; Spain ; Statistical models ; Subgroups ; Surgery ; Survival ; Survival Analysis ; Tumor cells ; Tumors ; Viruses ; α-Fetoprotein</subject><ispartof>Hepatology international, 2019-11, Vol.13 (6), p.726-735</ispartof><rights>Asian Pacific Association for the Study of the Liver 2019</rights><rights>Copyright Springer Nature B.V. 2019</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c375t-7dadcbcd27da9a384b61facea8fe7b487e76905f1b2ea3e349e66d8c6d5ae8ad3</citedby><cites>FETCH-LOGICAL-c375t-7dadcbcd27da9a384b61facea8fe7b487e76905f1b2ea3e349e66d8c6d5ae8ad3</cites><orcidid>0000-0002-7631-4124</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s12072-019-09994-9$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s12072-019-09994-9$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,780,784,27924,27925,41488,42557,51319</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31691073$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Ha, Yeonjung</creatorcontrib><creatorcontrib>Kim, Tae Hun</creatorcontrib><creatorcontrib>Shim, Jae Eul</creatorcontrib><creatorcontrib>Yoon, Sunghyun</creatorcontrib><creatorcontrib>Jun, Mi Jung</creatorcontrib><creatorcontrib>Cho, Young-Ho</creatorcontrib><creatorcontrib>Lee, Han Chu</creatorcontrib><title>Circulating tumor cells are associated with poor outcomes in early-stage hepatocellular carcinoma: a prospective study</title><title>Hepatology international</title><addtitle>Hepatol Int</addtitle><addtitle>Hepatol Int</addtitle><description>Background
Previous studies evaluating association between circulating tumor cells (CTCs) and clinical outcomes in hepatocellular carcinoma (HCC) have shown inconsistent results due to suboptimal detection methods and patient heterogeneity.
Methods
Patients undergoing surgery for early-stage HCC were prospectively enrolled. The CTC numbers were determined using a tapered slit platform, which detects CTCs based on the cell size and morphology. Survival and recurrence were evaluated, and Cox proportional hazards models were used to demonstrate the prognostic significance of CTC.
Results
Of 105 patients, 25 had increased CTC numbers after surgery (ΔCTC > 0, defined as positive) and a significantly higher level of recurrence (
p
= 0.042). A positive ΔCTC was seen to be an independent predictor of recurrence (hazard ratio 2.28), along with hepatitis B virus infection, alanine aminotransferase level, and the presence of satellite nodules (all
p
< 0.05). Subgroup analyses showed that a positive ΔCTC was associated with lower survival and higher recurrence among patients with low alpha-fetoprotein levels and cirrhosis (all
p
< 0.05).
Conclusion
Calculation of ΔCTC based on the physical properties of the cells is predictive of recurrence in patients with early HCC undergoing surgery.</description><subject>Alanine</subject><subject>Alanine transaminase</subject><subject>Biomarkers, Tumor - blood</subject><subject>Carcinoma, Hepatocellular - blood</subject><subject>Carcinoma, Hepatocellular - mortality</subject><subject>Carcinoma, Hepatocellular - pathology</subject><subject>Carcinoma, Hepatocellular - surgery</subject><subject>Cell size</subject><subject>Cell survival</subject><subject>Cirrhosis</subject><subject>Colorectal Surgery</subject><subject>Cytology</subject><subject>Female</subject><subject>Health hazards</subject><subject>Health risk assessment</subject><subject>Hepatitis</subject><subject>Hepatitis B</subject><subject>Hepatocellular carcinoma</subject><subject>Hepatology</subject><subject>Heterogeneity</subject><subject>Humans</subject><subject>Liver cancer</subject><subject>Liver cirrhosis</subject><subject>Liver Neoplasms - blood</subject><subject>Liver Neoplasms - mortality</subject><subject>Liver Neoplasms - pathology</subject><subject>Liver Neoplasms - surgery</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>Morphology</subject><subject>Neoplasm Recurrence, Local - blood</subject><subject>Neoplasm Recurrence, Local - mortality</subject><subject>Neoplasm Recurrence, Local - pathology</subject><subject>Neoplasm Recurrence, Local - surgery</subject><subject>Neoplasm Staging</subject><subject>Neoplastic Cells, Circulating</subject><subject>Nodules</subject><subject>Original Article</subject><subject>Patients</subject><subject>Physical properties</subject><subject>Predictive Value of Tests</subject><subject>Prognosis</subject><subject>Proportional Hazards Models</subject><subject>Prospective Studies</subject><subject>Spain</subject><subject>Statistical models</subject><subject>Subgroups</subject><subject>Surgery</subject><subject>Survival</subject><subject>Survival Analysis</subject><subject>Tumor cells</subject><subject>Tumors</subject><subject>Viruses</subject><subject>α-Fetoprotein</subject><issn>1936-0533</issn><issn>1936-0541</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kUtv3CAUhVHUKu8_kEWF1E03bsEYbLKrRm1TKVI37Rpdw_WEyDYu4ETz78t08pC66Ior3e8cDhxCrjj7yBlrPyVes7auGNcV01o3lT4ip1wLVTHZ8DcvsxAn5Cyle8akVFwdkxPBleasFafkYeOjXUfIft7SvE4hUovjmChEpJBSsB4yOvro8x1dQlmHNdswYaJ-pghx3FUpwxbpHS6Qw15c7IoLROvnMME1BbrEkBa02T8gTXl1uwvydoAx4eXTeU5-ff3yc3NT3f749n3z-bayopW5ah0421tXl0GD6Jpe8QEsQjdg2zddi63STA68rxEEikajUq6zyknADpw4Jx8OviXB7xVTNpNP-4wwY1iTqQWvpSw_2BT0_T_ofVjjXNLtKSkb1TFWqPpA2fKkFHEwS_QTxJ3hzOxbMYdWTPE0f1sxuojePVmv_YTuRfJcQwHEAUhlNW8xvt79H9s_9yWbMw</recordid><startdate>20191101</startdate><enddate>20191101</enddate><creator>Ha, Yeonjung</creator><creator>Kim, Tae Hun</creator><creator>Shim, Jae Eul</creator><creator>Yoon, Sunghyun</creator><creator>Jun, Mi Jung</creator><creator>Cho, Young-Ho</creator><creator>Lee, Han Chu</creator><general>Springer India</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7U7</scope><scope>C1K</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-7631-4124</orcidid></search><sort><creationdate>20191101</creationdate><title>Circulating tumor cells are associated with poor outcomes in early-stage hepatocellular carcinoma: a prospective study</title><author>Ha, Yeonjung ; Kim, Tae Hun ; Shim, Jae Eul ; Yoon, Sunghyun ; Jun, Mi Jung ; Cho, Young-Ho ; Lee, Han Chu</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c375t-7dadcbcd27da9a384b61facea8fe7b487e76905f1b2ea3e349e66d8c6d5ae8ad3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>Alanine</topic><topic>Alanine transaminase</topic><topic>Biomarkers, Tumor - blood</topic><topic>Carcinoma, Hepatocellular - blood</topic><topic>Carcinoma, Hepatocellular - mortality</topic><topic>Carcinoma, Hepatocellular - pathology</topic><topic>Carcinoma, Hepatocellular - surgery</topic><topic>Cell size</topic><topic>Cell survival</topic><topic>Cirrhosis</topic><topic>Colorectal Surgery</topic><topic>Cytology</topic><topic>Female</topic><topic>Health hazards</topic><topic>Health risk assessment</topic><topic>Hepatitis</topic><topic>Hepatitis B</topic><topic>Hepatocellular carcinoma</topic><topic>Hepatology</topic><topic>Heterogeneity</topic><topic>Humans</topic><topic>Liver cancer</topic><topic>Liver cirrhosis</topic><topic>Liver Neoplasms - blood</topic><topic>Liver Neoplasms - mortality</topic><topic>Liver Neoplasms - pathology</topic><topic>Liver Neoplasms - surgery</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Middle Aged</topic><topic>Morphology</topic><topic>Neoplasm Recurrence, Local - blood</topic><topic>Neoplasm Recurrence, Local - mortality</topic><topic>Neoplasm Recurrence, Local - pathology</topic><topic>Neoplasm Recurrence, Local - surgery</topic><topic>Neoplasm Staging</topic><topic>Neoplastic Cells, Circulating</topic><topic>Nodules</topic><topic>Original Article</topic><topic>Patients</topic><topic>Physical properties</topic><topic>Predictive Value of Tests</topic><topic>Prognosis</topic><topic>Proportional Hazards Models</topic><topic>Prospective Studies</topic><topic>Spain</topic><topic>Statistical models</topic><topic>Subgroups</topic><topic>Surgery</topic><topic>Survival</topic><topic>Survival Analysis</topic><topic>Tumor cells</topic><topic>Tumors</topic><topic>Viruses</topic><topic>α-Fetoprotein</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Ha, Yeonjung</creatorcontrib><creatorcontrib>Kim, Tae Hun</creatorcontrib><creatorcontrib>Shim, Jae Eul</creatorcontrib><creatorcontrib>Yoon, Sunghyun</creatorcontrib><creatorcontrib>Jun, Mi Jung</creatorcontrib><creatorcontrib>Cho, Young-Ho</creatorcontrib><creatorcontrib>Lee, Han Chu</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Toxicology Abstracts</collection><collection>Environmental Sciences and Pollution Management</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Premium</collection><collection>MEDLINE - Academic</collection><jtitle>Hepatology international</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Ha, Yeonjung</au><au>Kim, Tae Hun</au><au>Shim, Jae Eul</au><au>Yoon, Sunghyun</au><au>Jun, Mi Jung</au><au>Cho, Young-Ho</au><au>Lee, Han Chu</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Circulating tumor cells are associated with poor outcomes in early-stage hepatocellular carcinoma: a prospective study</atitle><jtitle>Hepatology international</jtitle><stitle>Hepatol Int</stitle><addtitle>Hepatol Int</addtitle><date>2019-11-01</date><risdate>2019</risdate><volume>13</volume><issue>6</issue><spage>726</spage><epage>735</epage><pages>726-735</pages><issn>1936-0533</issn><eissn>1936-0541</eissn><abstract>Background
Previous studies evaluating association between circulating tumor cells (CTCs) and clinical outcomes in hepatocellular carcinoma (HCC) have shown inconsistent results due to suboptimal detection methods and patient heterogeneity.
Methods
Patients undergoing surgery for early-stage HCC were prospectively enrolled. The CTC numbers were determined using a tapered slit platform, which detects CTCs based on the cell size and morphology. Survival and recurrence were evaluated, and Cox proportional hazards models were used to demonstrate the prognostic significance of CTC.
Results
Of 105 patients, 25 had increased CTC numbers after surgery (ΔCTC > 0, defined as positive) and a significantly higher level of recurrence (
p
= 0.042). A positive ΔCTC was seen to be an independent predictor of recurrence (hazard ratio 2.28), along with hepatitis B virus infection, alanine aminotransferase level, and the presence of satellite nodules (all
p
< 0.05). Subgroup analyses showed that a positive ΔCTC was associated with lower survival and higher recurrence among patients with low alpha-fetoprotein levels and cirrhosis (all
p
< 0.05).
Conclusion
Calculation of ΔCTC based on the physical properties of the cells is predictive of recurrence in patients with early HCC undergoing surgery.</abstract><cop>New Delhi</cop><pub>Springer India</pub><pmid>31691073</pmid><doi>10.1007/s12072-019-09994-9</doi><tpages>10</tpages><orcidid>https://orcid.org/0000-0002-7631-4124</orcidid></addata></record> |
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| ispartof | Hepatology international, 2019-11, Vol.13 (6), p.726-735 |
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| subjects | Alanine Alanine transaminase Biomarkers, Tumor - blood Carcinoma, Hepatocellular - blood Carcinoma, Hepatocellular - mortality Carcinoma, Hepatocellular - pathology Carcinoma, Hepatocellular - surgery Cell size Cell survival Cirrhosis Colorectal Surgery Cytology Female Health hazards Health risk assessment Hepatitis Hepatitis B Hepatocellular carcinoma Hepatology Heterogeneity Humans Liver cancer Liver cirrhosis Liver Neoplasms - blood Liver Neoplasms - mortality Liver Neoplasms - pathology Liver Neoplasms - surgery Male Medicine Medicine & Public Health Middle Aged Morphology Neoplasm Recurrence, Local - blood Neoplasm Recurrence, Local - mortality Neoplasm Recurrence, Local - pathology Neoplasm Recurrence, Local - surgery Neoplasm Staging Neoplastic Cells, Circulating Nodules Original Article Patients Physical properties Predictive Value of Tests Prognosis Proportional Hazards Models Prospective Studies Spain Statistical models Subgroups Surgery Survival Survival Analysis Tumor cells Tumors Viruses α-Fetoprotein |
| title | Circulating tumor cells are associated with poor outcomes in early-stage hepatocellular carcinoma: a prospective study |
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