Microscopic vascular invasion by hepatocellular carcinoma in liver transplant patients.

Clinical practice (London, England) Pub Date : 2020-01-01
Brian I Carr, Volkan Ince, Harika Gozukara Bag, Veysel Ersan, Sertac Usta, Sezai Yilmaz
{"title":"Microscopic vascular invasion by hepatocellular carcinoma in liver transplant patients.","authors":"Brian I Carr,&nbsp;Volkan Ince,&nbsp;Harika Gozukara Bag,&nbsp;Veysel Ersan,&nbsp;Sertac Usta,&nbsp;Sezai Yilmaz","doi":"","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>A characteristic of Hepatocellular Carcinoma (HCC) is to invade the portal venous system in the liver as a means of spread within the liver and systemically. The ensuing Portal Vein Thrombosis (PVT) is a poor prognosis parameter and often diagnosed radiologically pre-treatment. More limited Microvascular Portal Invasion (microPVI) is typically diagnosed on examination of tumors removed after treatment by resection or transplant. The biological characteristics and subsets of PVI are incompletely characterized.</p><p><strong>Aims: </strong>To examine HCC patients with and without microPVI to understand the clinical relationships to other tumor and clinical characteristics and to survival.</p><p><strong>Methods: </strong>A cohort of 270 liver transplant patients with HCC without macroscopic PVT that were available to us was examined. Patients with (165) and without (105) microPVI were compared for survival and clinical features.</p><p><strong>Results: </strong>The mean survival of patients with and without microPVI was significantly different: 86.6 versus 110.5 months, p=0.007.The microPVI+ patients differed from microPVI- patients in having a significantly larger number of tumor nodules, tumor size and higher serum levels of both Alpha-Fetoprotein (AFP) and almost significant for higher Gamma-Glutamyl Transpeptidase (GGT, p=0.053). Survival in microPVI+ patients related significantly to serum GGT (p=0.006) but not to AFP levels. The incidence of microPVI increased with increase in tumor size and survival decreased significantly with increase in tumor size for microPVI patients. Increase in tumor size was also associated with significantly higher serum GGT levels in patients who were microPVI+, but not in those who were microPVI. Furthermore, patients with microPVI who had prolonged survival significantly differed from those with shorter survival in respect only to tumor size and serum GGT levels.</p><p><strong>Conclusion: </strong>These findings draw attention to a group of patients with microPVI who have long survival and to the usefulness of serum GGT levels in their evaluation and prognosis.</p>","PeriodicalId":72620,"journal":{"name":"Clinical practice (London, England)","volume":"17 3","pages":"1497-1505"},"PeriodicalIF":0.0000,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7746034/pdf/nihms-1652505.pdf","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Clinical practice (London, England)","FirstCategoryId":"1085","ListUrlMain":"","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 0

Abstract

Background: A characteristic of Hepatocellular Carcinoma (HCC) is to invade the portal venous system in the liver as a means of spread within the liver and systemically. The ensuing Portal Vein Thrombosis (PVT) is a poor prognosis parameter and often diagnosed radiologically pre-treatment. More limited Microvascular Portal Invasion (microPVI) is typically diagnosed on examination of tumors removed after treatment by resection or transplant. The biological characteristics and subsets of PVI are incompletely characterized.

Aims: To examine HCC patients with and without microPVI to understand the clinical relationships to other tumor and clinical characteristics and to survival.

Methods: A cohort of 270 liver transplant patients with HCC without macroscopic PVT that were available to us was examined. Patients with (165) and without (105) microPVI were compared for survival and clinical features.

Results: The mean survival of patients with and without microPVI was significantly different: 86.6 versus 110.5 months, p=0.007.The microPVI+ patients differed from microPVI- patients in having a significantly larger number of tumor nodules, tumor size and higher serum levels of both Alpha-Fetoprotein (AFP) and almost significant for higher Gamma-Glutamyl Transpeptidase (GGT, p=0.053). Survival in microPVI+ patients related significantly to serum GGT (p=0.006) but not to AFP levels. The incidence of microPVI increased with increase in tumor size and survival decreased significantly with increase in tumor size for microPVI patients. Increase in tumor size was also associated with significantly higher serum GGT levels in patients who were microPVI+, but not in those who were microPVI. Furthermore, patients with microPVI who had prolonged survival significantly differed from those with shorter survival in respect only to tumor size and serum GGT levels.

Conclusion: These findings draw attention to a group of patients with microPVI who have long survival and to the usefulness of serum GGT levels in their evaluation and prognosis.

肝移植患者肝细胞癌的显微血管侵犯。
背景:肝细胞癌(HCC)的一个特点是侵入肝脏门静脉系统,并在肝脏内和全身扩散。继发的门静脉血栓形成(PVT)是一个不良预后参数,通常在治疗前通过放射学诊断。更有限的微血管门静脉侵入(Microvascular Portal Invasion, microPVI)通常是在肿瘤切除或移植后的检查中诊断出来的。PVI的生物学特性和亚群尚未完全确定。目的:探讨肝细胞癌伴及不伴微pvi患者与其他肿瘤、临床特征及生存的临床关系。方法:对270例无肉眼可见PVT的肝移植HCC患者进行队列研究。比较有(165)和无(105)微pvi患者的生存和临床特征。结果:微pvi患者与无微pvi患者的平均生存期有显著差异:86.6个月与110.5个月,p=0.007。微pvi +患者与微pvi -患者在肿瘤结节数量、肿瘤大小、血清甲胎蛋白(AFP)水平和γ -谷氨酰转肽酶(GGT)水平均显著高于微pvi -患者(p=0.053)。微pvi +患者的生存与血清GGT显著相关(p=0.006),但与AFP水平无关。微pvi患者的发病率随肿瘤大小的增加而增加,生存率随肿瘤大小的增加而显著降低。在微pvi +患者中,肿瘤大小的增加也与血清GGT水平的显著升高相关,而在微pvi患者中则无关。此外,仅在肿瘤大小和血清GGT水平方面,生存期较长的微型pvi患者与生存期较短的患者存在显著差异。结论:这些发现引起了人们对长期生存的微pvi患者的关注,并引起了血清GGT水平在其评估和预后中的作用。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 求助全文
来源期刊
自引率
0.00%
发文量
0
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信