{"title":"<sup>18</sup>F-FDG PET/CT Predicts the Prognosis of Patients with Hepatocellular Carcinoma Undergoing Liver Transplantation.","authors":"Wen-Jing Zheng, Yang Xu, Hui Tan, Shu-Guang Chen, Peng-Xiang Wang, Hai-Xiang Sun, Rui-Zhe Li, Hai-Ying Zeng, Yu-Chen Zhong, Jian-Wen Cheng, Jia Fan, Jian Zhou, Hongcheng Shi, Xin-Rong Yang","doi":"10.1159/000544966","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction: </strong>In addition to radical resection, liver transplantation (LTx) is an effective treatment for hepatocellular carcinoma (HCC). However, tumor recurrence limits the efficacy of LTx in some patients. This study investigated the role of <sup>18</sup>F-fludeoxyglucose (<sup>18</sup>F-FDG) positron emission tomography/computed tomography (PET/CT) in predicting the prognosis of patients with HCC after LTx.</p><p><strong>Methods: </strong>A total of 278 consecutive patients with HCC who underwent pre-LTx PET/CT were divided into derivation (<i>n</i> = 178) and temporal validation (<i>n</i> = 100) cohorts and evaluated for PET/CT values, immunohistochemical (IHC) findings, and DNA sequencing of tumor tissues.</p><p><strong>Results: </strong>Patients with post-LTx recurrence exhibited significantly higher tumor maximum standardized uptake values (SUVmax) in pre-LTx PET/CT scans. Receiver operating characteristic curve analyses identified the tumor SUVmax to liver SUVmax ratio (T<sub>SUVmax</sub>/L<sub>SUVmax</sub>) as the strongest predictor of post-LTx recurrence, with an optimal cutoff value of 1.43. Kaplan-Meier analyses demonstrated that a T<sub>SUVmax</sub>/L<sub>SUVmax</sub> >1.43 was associated with a shorter time to recurrence (TTR) and overall survival (OS) in both cohorts (<i>p</i> < 0.001 for both). Multivariate Cox regression analyses confirmed that T<sub>SUVmax</sub>/L<sub>SUVmax</sub> >1.43 was an independent risk factor for tumor recurrence in both cohorts. IHC revealed that T<sub>SUVmax</sub>/L<sub>SUVmax</sub> >1.43 correlated with higher Ki-67 and CK19 expression. DNA sequencing indicated that tumors with T<sub>SUVmax</sub>/L<sub>SUVmax</sub> >1.43 had more mutations and a higher TMB. Furthermore, T<sub>SUVmax</sub>/L<sub>SUVmax</sub> >1.43 was significantly associated with mutations in <i>TP53</i>, <i>EPPK1</i>, <i>MDM4</i>, <i>SLAMF7</i>, <i>SDHC</i>, <i>B4GALT3</i>, <i>RXRG</i>, and FCGR family genes, as well as TP53 and PI3K signaling-related alterations.</p><p><strong>Conclusions: </strong>The preoperative T<sub>SUVmax</sub>/L<sub>SUVmax</sub> is a potential predictor of tumor recurrence in patients with HCC following LTx. Its use improves candidate selection and post-LTx management.</p>","PeriodicalId":18156,"journal":{"name":"Liver Cancer","volume":" ","pages":"1-21"},"PeriodicalIF":11.6000,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11998673/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Liver Cancer","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1159/000544966","RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"GASTROENTEROLOGY & HEPATOLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
Introduction: In addition to radical resection, liver transplantation (LTx) is an effective treatment for hepatocellular carcinoma (HCC). However, tumor recurrence limits the efficacy of LTx in some patients. This study investigated the role of 18F-fludeoxyglucose (18F-FDG) positron emission tomography/computed tomography (PET/CT) in predicting the prognosis of patients with HCC after LTx.
Methods: A total of 278 consecutive patients with HCC who underwent pre-LTx PET/CT were divided into derivation (n = 178) and temporal validation (n = 100) cohorts and evaluated for PET/CT values, immunohistochemical (IHC) findings, and DNA sequencing of tumor tissues.
Results: Patients with post-LTx recurrence exhibited significantly higher tumor maximum standardized uptake values (SUVmax) in pre-LTx PET/CT scans. Receiver operating characteristic curve analyses identified the tumor SUVmax to liver SUVmax ratio (TSUVmax/LSUVmax) as the strongest predictor of post-LTx recurrence, with an optimal cutoff value of 1.43. Kaplan-Meier analyses demonstrated that a TSUVmax/LSUVmax >1.43 was associated with a shorter time to recurrence (TTR) and overall survival (OS) in both cohorts (p < 0.001 for both). Multivariate Cox regression analyses confirmed that TSUVmax/LSUVmax >1.43 was an independent risk factor for tumor recurrence in both cohorts. IHC revealed that TSUVmax/LSUVmax >1.43 correlated with higher Ki-67 and CK19 expression. DNA sequencing indicated that tumors with TSUVmax/LSUVmax >1.43 had more mutations and a higher TMB. Furthermore, TSUVmax/LSUVmax >1.43 was significantly associated with mutations in TP53, EPPK1, MDM4, SLAMF7, SDHC, B4GALT3, RXRG, and FCGR family genes, as well as TP53 and PI3K signaling-related alterations.
Conclusions: The preoperative TSUVmax/LSUVmax is a potential predictor of tumor recurrence in patients with HCC following LTx. Its use improves candidate selection and post-LTx management.
期刊介绍：
Liver Cancer is a journal that serves the international community of researchers and clinicians by providing a platform for research results related to the causes, mechanisms, and therapy of liver cancer. It focuses on molecular carcinogenesis, prevention, surveillance, diagnosis, and treatment, including molecular targeted therapy. The journal publishes clinical and translational research in the field of liver cancer in both humans and experimental models. It publishes original and review articles and has an Impact Factor of 13.8. The journal is indexed and abstracted in various platforms including PubMed, PubMed Central, Web of Science, Science Citation Index, Science Citation Index Expanded, Google Scholar, DOAJ, Chemical Abstracts Service, Scopus, Embase, Pathway Studio, and WorldCat.
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