Combinations of biomarkers and Milan criteria for predicting hepatocellular carcinoma recurrence after liver transplantation
Growing evidence suggests that pretransplant alpha‐fetoprotein (AFP) predicts outcomes of hepatocellular carcinoma (HCC) patients treated with liver transplantation. We aimed to determine whether pretransplant AFP, Lens culinaris agglutinin‐reactive alpha‐fetoprotein (AFP‐L3), and des‐gamma‐carboxyp...
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| creator | Chaiteerakij, Roongruedee Zhang, Xiaodan Addissie, Benyam D. Mohamed, Essa A. Harmsen, William S. Theobald, Paul J. Peters, Brian E. Balsanek, Joseph G. Ward, Melissa M. Giama, Nasra H. Moser, Catherine D. Oseini, Abdul M. Umeda, Naoki Venkatesh, Sudhakar Harnois, Denise M. Charlton, Michael R. Yamada, Hiroyuki Satomura, Shinji Algeciras‐Schimnich, Alicia Snyder, Melissa R. Therneau, Terry M. Roberts, Lewis R. |
| description | Growing evidence suggests that pretransplant alpha‐fetoprotein (AFP) predicts outcomes of hepatocellular carcinoma (HCC) patients treated with liver transplantation. We aimed to determine whether pretransplant AFP, Lens culinaris agglutinin‐reactive alpha‐fetoprotein (AFP‐L3), and des‐gamma‐carboxyprothrombin (DCP) predicted HCC recurrence after transplantation. A retrospective cohort study of 313 HCC patients undergoing transplantation between 2000 and 2008 was conducted, and 48 (15.3%) developed recurrence during a median follow‐up of 90.8 months. The 127 patients with available serum drawn before transplantation were included; they included 86 without recurrence and 41 with recurrence. Serum was tested for AFP, AFP‐L3%, and DCP in a blinded fashion with the μTASWako i30 immunoanalyzer. All biomarkers were significantly associated with HCC recurrence. The hazard ratios (HRs) were 3.5 [95% confidence interval (CI), 1.9‐6.7; P |
| doi_str_mv | 10.1002/lt.24117 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_4490162</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1676596700</sourcerecordid><originalsourceid>FETCH-LOGICAL-c5047-3d652086a7fe914046bab67c5b4f13b26687c6ae6a656b3db6dd76396a0690793</originalsourceid><addsrcrecordid>eNp1kU1r3DAQhk1padK00F9QBL304lSyrZF9KZSlX7All-QsRrKcKNVKriQnBPLjo82mm6bQiyTQM8_My1TVW0aPGaXNR5ePm44x8aw6ZLwRNXSifb5_Az-oXqV0SSljfKAvq4OGi36Alh9Wt6uwUdZjtsEnEiaibNhg_GViIuhH8tM69ERHm020SKYQyRzNaHW2_pxcmBlz0Ma5xWEkGqO2vtSTaPQSo_HaEJxKKXH2qpw5ok9zMeb7hq-rFxO6ZN483EfV2dcvp6vv9frk24_V53WtOe1E3Y7AG9oDiskMrKMdKFQgNFfdxFrVAPRCAxpA4KDaUcE4CmgHQAoDFUN7VH3aeedFbcyojS-DODlHW6LeyIBWPv3x9kKehyvZdQNl0BTBhwdBDL8Xk7Lc2LSNjd6EJUkGAvgAgtKCvv8HvQxL9CXeluJt04tePAp1DClFM-2HYVRuVypdlvcrLei7v4ffg392WIB6B1xbZ27-K5Lr053wDi1ErPw</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1675328787</pqid></control><display><type>article</type><title>Combinations of biomarkers and Milan criteria for predicting hepatocellular carcinoma recurrence after liver transplantation</title><source>MEDLINE</source><source>Wiley Online Library Journals Frontfile Complete</source><source>Alma/SFX Local Collection</source><creator>Chaiteerakij, Roongruedee ; Zhang, Xiaodan ; Addissie, Benyam D. ; Mohamed, Essa A. ; Harmsen, William S. ; Theobald, Paul J. ; Peters, Brian E. ; Balsanek, Joseph G. ; Ward, Melissa M. ; Giama, Nasra H. ; Moser, Catherine D. ; Oseini, Abdul M. ; Umeda, Naoki ; Venkatesh, Sudhakar ; Harnois, Denise M. ; Charlton, Michael R. ; Yamada, Hiroyuki ; Satomura, Shinji ; Algeciras‐Schimnich, Alicia ; Snyder, Melissa R. ; Therneau, Terry M. ; Roberts, Lewis R.</creator><creatorcontrib>Chaiteerakij, Roongruedee ; Zhang, Xiaodan ; Addissie, Benyam D. ; Mohamed, Essa A. ; Harmsen, William S. ; Theobald, Paul J. ; Peters, Brian E. ; Balsanek, Joseph G. ; Ward, Melissa M. ; Giama, Nasra H. ; Moser, Catherine D. ; Oseini, Abdul M. ; Umeda, Naoki ; Venkatesh, Sudhakar ; Harnois, Denise M. ; Charlton, Michael R. ; Yamada, Hiroyuki ; Satomura, Shinji ; Algeciras‐Schimnich, Alicia ; Snyder, Melissa R. ; Therneau, Terry M. ; Roberts, Lewis R.</creatorcontrib><description>Growing evidence suggests that pretransplant alpha‐fetoprotein (AFP) predicts outcomes of hepatocellular carcinoma (HCC) patients treated with liver transplantation. We aimed to determine whether pretransplant AFP, Lens culinaris agglutinin‐reactive alpha‐fetoprotein (AFP‐L3), and des‐gamma‐carboxyprothrombin (DCP) predicted HCC recurrence after transplantation. A retrospective cohort study of 313 HCC patients undergoing transplantation between 2000 and 2008 was conducted, and 48 (15.3%) developed recurrence during a median follow‐up of 90.8 months. The 127 patients with available serum drawn before transplantation were included; they included 86 without recurrence and 41 with recurrence. Serum was tested for AFP, AFP‐L3%, and DCP in a blinded fashion with the μTASWako i30 immunoanalyzer. All biomarkers were significantly associated with HCC recurrence. The hazard ratios (HRs) were 3.5 [95% confidence interval (CI), 1.9‐6.7; P < 0.0001] for DCP ≥ 7.5 ng/mL and 2.8 (95% CI, 1.4‐5.4; P = 0.002) for AFP ≥ 250 ng/mL. The HR increased to 5.2 (95% CI, 2.3‐12.0; P < 0.0001) when AFP ≥ 250 ng/mL and DCP ≥7.5 ng/mL were considered together. When they were combined with the Milan criteria, the HR increased from 2.6 (95% CI, 1.4‐4.7; P = 0.003) for outside the Milan criteria to 8.6 (95% CI, 3.0‐24.6; P < 0.0001) for outside the Milan criteria and AFP ≥ 250 ng/mL and to 7.2 (95% CI, 2.8‐18.1; P < 0.0001) for outside the Milan criteria and DCP ≥7.5 ng/mL. Our findings suggest that biomarkers are useful for predicting the risk of HCC recurrence after transplantation. Using both biomarkers and the Milan criteria may be better than using the Milan criteria alone in optimizing the decision of liver transplantation eligibility. Liver Transpl 21:599–606, 2015. © 2015 AASLD.</description><identifier>ISSN: 1527-6465</identifier><identifier>EISSN: 1527-6473</identifier><identifier>DOI: 10.1002/lt.24117</identifier><identifier>PMID: 25789635</identifier><identifier>CODEN: LITRFO</identifier><language>eng</language><publisher>United States: Wolters Kluwer Health, Inc</publisher><subject>Aged ; alpha-Fetoproteins - metabolism ; Biomarkers ; Biomarkers - metabolism ; Carcinoma, Hepatocellular - diagnosis ; Carcinoma, Hepatocellular - pathology ; Carcinoma, Hepatocellular - surgery ; Cohort Studies ; Confidence intervals ; Female ; Humans ; Liver cancer ; Liver cirrhosis ; Liver Neoplasms - diagnosis ; Liver Neoplasms - pathology ; Liver Neoplasms - surgery ; Liver Transplantation - methods ; Male ; Middle Aged ; Neoplasm Recurrence, Local - diagnosis ; Neoplasm Recurrence, Local - pathology ; Plant Lectins - chemistry ; Proportional Hazards Models ; Protein Precursors - metabolism ; Prothrombin - metabolism ; Retrospective Studies ; Severity of Illness Index ; Signal Transduction ; Tomography, X-Ray Computed - methods ; Transplants & implants</subject><ispartof>Liver transplantation, 2015-05, Vol.21 (5), p.599-606</ispartof><rights>2015 American Association for the Study of Liver Diseases</rights><rights>2015 American Association for the Study of Liver Diseases.</rights><rights>2015 American Association for the Study of Liver Diseases. 2015</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c5047-3d652086a7fe914046bab67c5b4f13b26687c6ae6a656b3db6dd76396a0690793</citedby><cites>FETCH-LOGICAL-c5047-3d652086a7fe914046bab67c5b4f13b26687c6ae6a656b3db6dd76396a0690793</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1002%2Flt.24117$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1002%2Flt.24117$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>230,314,776,780,881,1411,27901,27902,45550,45551</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/25789635$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Chaiteerakij, Roongruedee</creatorcontrib><creatorcontrib>Zhang, Xiaodan</creatorcontrib><creatorcontrib>Addissie, Benyam D.</creatorcontrib><creatorcontrib>Mohamed, Essa A.</creatorcontrib><creatorcontrib>Harmsen, William S.</creatorcontrib><creatorcontrib>Theobald, Paul J.</creatorcontrib><creatorcontrib>Peters, Brian E.</creatorcontrib><creatorcontrib>Balsanek, Joseph G.</creatorcontrib><creatorcontrib>Ward, Melissa M.</creatorcontrib><creatorcontrib>Giama, Nasra H.</creatorcontrib><creatorcontrib>Moser, Catherine D.</creatorcontrib><creatorcontrib>Oseini, Abdul M.</creatorcontrib><creatorcontrib>Umeda, Naoki</creatorcontrib><creatorcontrib>Venkatesh, Sudhakar</creatorcontrib><creatorcontrib>Harnois, Denise M.</creatorcontrib><creatorcontrib>Charlton, Michael R.</creatorcontrib><creatorcontrib>Yamada, Hiroyuki</creatorcontrib><creatorcontrib>Satomura, Shinji</creatorcontrib><creatorcontrib>Algeciras‐Schimnich, Alicia</creatorcontrib><creatorcontrib>Snyder, Melissa R.</creatorcontrib><creatorcontrib>Therneau, Terry M.</creatorcontrib><creatorcontrib>Roberts, Lewis R.</creatorcontrib><title>Combinations of biomarkers and Milan criteria for predicting hepatocellular carcinoma recurrence after liver transplantation</title><title>Liver transplantation</title><addtitle>Liver Transpl</addtitle><description>Growing evidence suggests that pretransplant alpha‐fetoprotein (AFP) predicts outcomes of hepatocellular carcinoma (HCC) patients treated with liver transplantation. We aimed to determine whether pretransplant AFP, Lens culinaris agglutinin‐reactive alpha‐fetoprotein (AFP‐L3), and des‐gamma‐carboxyprothrombin (DCP) predicted HCC recurrence after transplantation. A retrospective cohort study of 313 HCC patients undergoing transplantation between 2000 and 2008 was conducted, and 48 (15.3%) developed recurrence during a median follow‐up of 90.8 months. The 127 patients with available serum drawn before transplantation were included; they included 86 without recurrence and 41 with recurrence. Serum was tested for AFP, AFP‐L3%, and DCP in a blinded fashion with the μTASWako i30 immunoanalyzer. All biomarkers were significantly associated with HCC recurrence. The hazard ratios (HRs) were 3.5 [95% confidence interval (CI), 1.9‐6.7; P < 0.0001] for DCP ≥ 7.5 ng/mL and 2.8 (95% CI, 1.4‐5.4; P = 0.002) for AFP ≥ 250 ng/mL. The HR increased to 5.2 (95% CI, 2.3‐12.0; P < 0.0001) when AFP ≥ 250 ng/mL and DCP ≥7.5 ng/mL were considered together. When they were combined with the Milan criteria, the HR increased from 2.6 (95% CI, 1.4‐4.7; P = 0.003) for outside the Milan criteria to 8.6 (95% CI, 3.0‐24.6; P < 0.0001) for outside the Milan criteria and AFP ≥ 250 ng/mL and to 7.2 (95% CI, 2.8‐18.1; P < 0.0001) for outside the Milan criteria and DCP ≥7.5 ng/mL. Our findings suggest that biomarkers are useful for predicting the risk of HCC recurrence after transplantation. Using both biomarkers and the Milan criteria may be better than using the Milan criteria alone in optimizing the decision of liver transplantation eligibility. Liver Transpl 21:599–606, 2015. © 2015 AASLD.</description><subject>Aged</subject><subject>alpha-Fetoproteins - metabolism</subject><subject>Biomarkers</subject><subject>Biomarkers - metabolism</subject><subject>Carcinoma, Hepatocellular - diagnosis</subject><subject>Carcinoma, Hepatocellular - pathology</subject><subject>Carcinoma, Hepatocellular - surgery</subject><subject>Cohort Studies</subject><subject>Confidence intervals</subject><subject>Female</subject><subject>Humans</subject><subject>Liver cancer</subject><subject>Liver cirrhosis</subject><subject>Liver Neoplasms - diagnosis</subject><subject>Liver Neoplasms - pathology</subject><subject>Liver Neoplasms - surgery</subject><subject>Liver Transplantation - methods</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Neoplasm Recurrence, Local - diagnosis</subject><subject>Neoplasm Recurrence, Local - pathology</subject><subject>Plant Lectins - chemistry</subject><subject>Proportional Hazards Models</subject><subject>Protein Precursors - metabolism</subject><subject>Prothrombin - metabolism</subject><subject>Retrospective Studies</subject><subject>Severity of Illness Index</subject><subject>Signal Transduction</subject><subject>Tomography, X-Ray Computed - methods</subject><subject>Transplants & implants</subject><issn>1527-6465</issn><issn>1527-6473</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2015</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1kU1r3DAQhk1padK00F9QBL304lSyrZF9KZSlX7All-QsRrKcKNVKriQnBPLjo82mm6bQiyTQM8_My1TVW0aPGaXNR5ePm44x8aw6ZLwRNXSifb5_Az-oXqV0SSljfKAvq4OGi36Alh9Wt6uwUdZjtsEnEiaibNhg_GViIuhH8tM69ERHm020SKYQyRzNaHW2_pxcmBlz0Ma5xWEkGqO2vtSTaPQSo_HaEJxKKXH2qpw5ok9zMeb7hq-rFxO6ZN483EfV2dcvp6vv9frk24_V53WtOe1E3Y7AG9oDiskMrKMdKFQgNFfdxFrVAPRCAxpA4KDaUcE4CmgHQAoDFUN7VH3aeedFbcyojS-DODlHW6LeyIBWPv3x9kKehyvZdQNl0BTBhwdBDL8Xk7Lc2LSNjd6EJUkGAvgAgtKCvv8HvQxL9CXeluJt04tePAp1DClFM-2HYVRuVypdlvcrLei7v4ffg392WIB6B1xbZ27-K5Lr053wDi1ErPw</recordid><startdate>201505</startdate><enddate>201505</enddate><creator>Chaiteerakij, Roongruedee</creator><creator>Zhang, Xiaodan</creator><creator>Addissie, Benyam D.</creator><creator>Mohamed, Essa A.</creator><creator>Harmsen, William S.</creator><creator>Theobald, Paul J.</creator><creator>Peters, Brian E.</creator><creator>Balsanek, Joseph G.</creator><creator>Ward, Melissa M.</creator><creator>Giama, Nasra H.</creator><creator>Moser, Catherine D.</creator><creator>Oseini, Abdul M.</creator><creator>Umeda, Naoki</creator><creator>Venkatesh, Sudhakar</creator><creator>Harnois, Denise M.</creator><creator>Charlton, Michael R.</creator><creator>Yamada, Hiroyuki</creator><creator>Satomura, Shinji</creator><creator>Algeciras‐Schimnich, Alicia</creator><creator>Snyder, Melissa R.</creator><creator>Therneau, Terry M.</creator><creator>Roberts, Lewis R.</creator><general>Wolters Kluwer Health, Inc</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>K9.</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>201505</creationdate><title>Combinations of biomarkers and Milan criteria for predicting hepatocellular carcinoma recurrence after liver transplantation</title><author>Chaiteerakij, Roongruedee ; Zhang, Xiaodan ; Addissie, Benyam D. ; Mohamed, Essa A. ; Harmsen, William S. ; Theobald, Paul J. ; Peters, Brian E. ; Balsanek, Joseph G. ; Ward, Melissa M. ; Giama, Nasra H. ; Moser, Catherine D. ; Oseini, Abdul M. ; Umeda, Naoki ; Venkatesh, Sudhakar ; Harnois, Denise M. ; Charlton, Michael R. ; Yamada, Hiroyuki ; Satomura, Shinji ; Algeciras‐Schimnich, Alicia ; Snyder, Melissa R. ; Therneau, Terry M. ; Roberts, Lewis R.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c5047-3d652086a7fe914046bab67c5b4f13b26687c6ae6a656b3db6dd76396a0690793</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2015</creationdate><topic>Aged</topic><topic>alpha-Fetoproteins - metabolism</topic><topic>Biomarkers</topic><topic>Biomarkers - metabolism</topic><topic>Carcinoma, Hepatocellular - diagnosis</topic><topic>Carcinoma, Hepatocellular - pathology</topic><topic>Carcinoma, Hepatocellular - surgery</topic><topic>Cohort Studies</topic><topic>Confidence intervals</topic><topic>Female</topic><topic>Humans</topic><topic>Liver cancer</topic><topic>Liver cirrhosis</topic><topic>Liver Neoplasms - diagnosis</topic><topic>Liver Neoplasms - pathology</topic><topic>Liver Neoplasms - surgery</topic><topic>Liver Transplantation - methods</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Neoplasm Recurrence, Local - diagnosis</topic><topic>Neoplasm Recurrence, Local - pathology</topic><topic>Plant Lectins - chemistry</topic><topic>Proportional Hazards Models</topic><topic>Protein Precursors - metabolism</topic><topic>Prothrombin - metabolism</topic><topic>Retrospective Studies</topic><topic>Severity of Illness Index</topic><topic>Signal Transduction</topic><topic>Tomography, X-Ray Computed - methods</topic><topic>Transplants & implants</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Chaiteerakij, Roongruedee</creatorcontrib><creatorcontrib>Zhang, Xiaodan</creatorcontrib><creatorcontrib>Addissie, Benyam D.</creatorcontrib><creatorcontrib>Mohamed, Essa A.</creatorcontrib><creatorcontrib>Harmsen, William S.</creatorcontrib><creatorcontrib>Theobald, Paul J.</creatorcontrib><creatorcontrib>Peters, Brian E.</creatorcontrib><creatorcontrib>Balsanek, Joseph G.</creatorcontrib><creatorcontrib>Ward, Melissa M.</creatorcontrib><creatorcontrib>Giama, Nasra H.</creatorcontrib><creatorcontrib>Moser, Catherine D.</creatorcontrib><creatorcontrib>Oseini, Abdul M.</creatorcontrib><creatorcontrib>Umeda, Naoki</creatorcontrib><creatorcontrib>Venkatesh, Sudhakar</creatorcontrib><creatorcontrib>Harnois, Denise M.</creatorcontrib><creatorcontrib>Charlton, Michael R.</creatorcontrib><creatorcontrib>Yamada, Hiroyuki</creatorcontrib><creatorcontrib>Satomura, Shinji</creatorcontrib><creatorcontrib>Algeciras‐Schimnich, Alicia</creatorcontrib><creatorcontrib>Snyder, Melissa R.</creatorcontrib><creatorcontrib>Therneau, Terry M.</creatorcontrib><creatorcontrib>Roberts, Lewis R.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Liver transplantation</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Chaiteerakij, Roongruedee</au><au>Zhang, Xiaodan</au><au>Addissie, Benyam D.</au><au>Mohamed, Essa A.</au><au>Harmsen, William S.</au><au>Theobald, Paul J.</au><au>Peters, Brian E.</au><au>Balsanek, Joseph G.</au><au>Ward, Melissa M.</au><au>Giama, Nasra H.</au><au>Moser, Catherine D.</au><au>Oseini, Abdul M.</au><au>Umeda, Naoki</au><au>Venkatesh, Sudhakar</au><au>Harnois, Denise M.</au><au>Charlton, Michael R.</au><au>Yamada, Hiroyuki</au><au>Satomura, Shinji</au><au>Algeciras‐Schimnich, Alicia</au><au>Snyder, Melissa R.</au><au>Therneau, Terry M.</au><au>Roberts, Lewis R.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Combinations of biomarkers and Milan criteria for predicting hepatocellular carcinoma recurrence after liver transplantation</atitle><jtitle>Liver transplantation</jtitle><addtitle>Liver Transpl</addtitle><date>2015-05</date><risdate>2015</risdate><volume>21</volume><issue>5</issue><spage>599</spage><epage>606</epage><pages>599-606</pages><issn>1527-6465</issn><eissn>1527-6473</eissn><coden>LITRFO</coden><abstract>Growing evidence suggests that pretransplant alpha‐fetoprotein (AFP) predicts outcomes of hepatocellular carcinoma (HCC) patients treated with liver transplantation. We aimed to determine whether pretransplant AFP, Lens culinaris agglutinin‐reactive alpha‐fetoprotein (AFP‐L3), and des‐gamma‐carboxyprothrombin (DCP) predicted HCC recurrence after transplantation. A retrospective cohort study of 313 HCC patients undergoing transplantation between 2000 and 2008 was conducted, and 48 (15.3%) developed recurrence during a median follow‐up of 90.8 months. The 127 patients with available serum drawn before transplantation were included; they included 86 without recurrence and 41 with recurrence. Serum was tested for AFP, AFP‐L3%, and DCP in a blinded fashion with the μTASWako i30 immunoanalyzer. All biomarkers were significantly associated with HCC recurrence. The hazard ratios (HRs) were 3.5 [95% confidence interval (CI), 1.9‐6.7; P < 0.0001] for DCP ≥ 7.5 ng/mL and 2.8 (95% CI, 1.4‐5.4; P = 0.002) for AFP ≥ 250 ng/mL. The HR increased to 5.2 (95% CI, 2.3‐12.0; P < 0.0001) when AFP ≥ 250 ng/mL and DCP ≥7.5 ng/mL were considered together. When they were combined with the Milan criteria, the HR increased from 2.6 (95% CI, 1.4‐4.7; P = 0.003) for outside the Milan criteria to 8.6 (95% CI, 3.0‐24.6; P < 0.0001) for outside the Milan criteria and AFP ≥ 250 ng/mL and to 7.2 (95% CI, 2.8‐18.1; P < 0.0001) for outside the Milan criteria and DCP ≥7.5 ng/mL. Our findings suggest that biomarkers are useful for predicting the risk of HCC recurrence after transplantation. Using both biomarkers and the Milan criteria may be better than using the Milan criteria alone in optimizing the decision of liver transplantation eligibility. Liver Transpl 21:599–606, 2015. © 2015 AASLD.</abstract><cop>United States</cop><pub>Wolters Kluwer Health, Inc</pub><pmid>25789635</pmid><doi>10.1002/lt.24117</doi><tpages>10</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Aged alpha-Fetoproteins - metabolism Biomarkers Biomarkers - metabolism Carcinoma, Hepatocellular - diagnosis Carcinoma, Hepatocellular - pathology Carcinoma, Hepatocellular - surgery Cohort Studies Confidence intervals Female Humans Liver cancer Liver cirrhosis Liver Neoplasms - diagnosis Liver Neoplasms - pathology Liver Neoplasms - surgery Liver Transplantation - methods Male Middle Aged Neoplasm Recurrence, Local - diagnosis Neoplasm Recurrence, Local - pathology Plant Lectins - chemistry Proportional Hazards Models Protein Precursors - metabolism Prothrombin - metabolism Retrospective Studies Severity of Illness Index Signal Transduction Tomography, X-Ray Computed - methods Transplants & implants |
| title | Combinations of biomarkers and Milan criteria for predicting hepatocellular carcinoma recurrence after liver transplantation |
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