PMID- 16003238
OWN - NLM
STAT- MEDLINE
DCOM- 20050926
LR  - 20190713
IS  - 0041-1337 (Print)
IS  - 0041-1337 (Linking)
VI  - 80
IP  - 1
DP  - 2005 Jul 15
TI  - Detection and clinical significance of bone marrow micrometastases in patients 
      undergoing liver transplantation for hepatocellular carcinoma.
PG  - 88-94
AB  - BACKGROUND: Existing methods of selecting patients with hepatocellular carcinoma 
      (HCC) for liver transplantation rely on computed tomography and magnetic 
      resonance imaging, which fail to detect vascular invasion or micrometastases. 
      Vascular invasion cannot be assessed pretransplant because of the risks of tumor 
      biopsy. Pretransplant detection of micrometastases in bone marrow is an 
      alternative method that may identify patients at risk of recurrence and permit 
      better organ allocation. The authors' aim was to develop an accurate method of 
      detecting hepatocellular carcinoma micrometastases that may have a clinical role 
      in pretransplant assessment. METHODS: Iliac crest bone marrow was sampled from 18 
      patients with HCC (before liver transplantation) and 14 controls (cirrhosis, 9; 
      hematologic disorders, 5). Mononuclear bone marrow fractions were evaluated for 
      the presence of micrometastases by immunocytochemistry (ICC) using Hep Par-1 
      (HPICC) and Glypican-3 (GPICC), and by reverse-transcriptase (RT) polymerase 
      chain reaction using two primer pairs targeting albumin (Alb1RT and Alb2RT) and 
      one pair targeting alpha-fetoprotein (AFPRT). Each marker was compared in terms 
      of (1) specificity and (2) positive and negative predictive values for tumor 
      recurrence. RESULTS: The specificity of each marker for detecting HCC 
      micrometastases were as follows: HPICC, 93%; GPICC, 92%; Alb1RT, 33%; Alb2RT, 
      59%; and AFPRT, 0%. The positive (negative) predictive values for HPICC, GPICC, 
      and Alb2RT for posttransplant tumor recurrence were 42% (100%), 40% (73%), and 0% 
      (43%), respectively. HPICC-positive micrometastases were identified in all 
      patients with postoperative tumor recurrence (n=5) and in 75% of patients with 
      microscopic vascular invasion. CONCLUSIONS: Detection of HCC micrometastases in 
      bone marrow of potential liver transplant candidates is a potentially useful 
      technique that may provide important prognostic information without the need for 
      preoperative tumor biopsy. The authors' preliminary data indicate that HPICC is a 
      promising immunocytochemical marker for HCC micrometastases, and larger studies 
      are needed to confirm its clinical role.
FAU - Sutcliffe, Robert
AU  - Sutcliffe R
AD  - Liver Transplant Unit, King's College Hospital, London, United Kingdom.
FAU - Maguire, Donal
AU  - Maguire D
FAU - Murphy, Philip
AU  - Murphy P
FAU - Portmann, Bernard
AU  - Portmann B
FAU - Rela, Mohamed
AU  - Rela M
FAU - O'Sullivan, Gerald
AU  - O'Sullivan G
FAU - Mufti, Ghulam
AU  - Mufti G
FAU - Heaton, Nigel
AU  - Heaton N
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Transplantation
JT  - Transplantation
JID - 0132144
RN  - 0 (Actins)
RN  - 0 (DNA Primers)
SB  - IM
MH  - Actins/genetics
MH  - Adult
MH  - Aged
MH  - Base Sequence
MH  - Biopsy, Needle
MH  - Bone Marrow/*pathology
MH  - Cadaver
MH  - Carcinoma, Hepatocellular/*pathology/*surgery
MH  - DNA Primers
MH  - Female
MH  - Hematologic Diseases/pathology
MH  - Hepatocytes/pathology
MH  - Humans
MH  - Liver Cirrhosis/pathology
MH  - Liver Neoplasms/*pathology/*surgery
MH  - Liver Transplantation/*pathology
MH  - Male
MH  - Middle Aged
MH  - Neoplasm Invasiveness
MH  - Neoplasm Metastasis/*pathology
MH  - Reverse Transcriptase Polymerase Chain Reaction
MH  - Tissue Donors
EDAT- 2005/07/09 09:00
MHDA- 2005/09/27 09:00
CRDT- 2005/07/09 09:00
PHST- 2005/07/09 09:00 [pubmed]
PHST- 2005/09/27 09:00 [medline]
PHST- 2005/07/09 09:00 [entrez]
AID - 00007890-200507150-00016 [pii]
AID - 10.1097/01.tp.0000164499.40952.c8 [doi]
PST - ppublish
SO  - Transplantation. 2005 Jul 15;80(1):88-94. doi: 10.1097/01.tp.0000164499.40952.c8.