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EpCAM-positive circulating tumor cells and serum AFP levels predict outcome after curative resection of hepatocellular carcinoma

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posted on 2024-01-19, 08:27 authored by Lorenz Kocheise, Martin Schoenlein, Berit Behrends, Vincent Joerg, Christian Casar, Thorben W Fruendt, Thomas Renné, Asmus Heumann, Jun Li, Samuel Huber, Ansgar W Lohse, Klaus Pantel, Sabine Riethdorf, Henning Wege, Kornelius Schulze, Johann von Felden

Hepatocellular carcinoma (HCC) has high recurrence rates exceeding 50% despite curative resection. The serum biomarker alpha-fetoprotein (AFP) is a well-known prognostic marker for HCC. EpCAM-positive circulating tumor cells (CTC) have a high predictive value for early HCC recurrence after curatively intended resection, most likely indicating micro-metastases at the time of resection. However, sensitivity remains low. The objective of this study was to evaluate a composite test comprising both CTC and AFP to identify patients at high risk for early HCC recurrence. We prospectively enrolled 58 patients undergoing curative intended resection for HCC at a tertiary referral center. Blood specimens were obtained prior to resection and analyzed for EpCAM-positive CTC and serum AFP levels. A positive result was defined as either detection of CTC or AFP levels ≥ 400 ng/ml. Eight patients tested positive for CTC, seven for AFP, and two for both markers. A positive composite test was significantly associated with shorter early recurrence-free survival (5 vs. 16 months, p = 0.005), time to recurrence (5 vs. 16 months, p = 0.011), and overall survival (37 vs. not reached, p = 0.034). Combining CTC and AFP identified patients with poor outcome after surgical resection, for whom adjuvant or neoadjuvant therapies may be particularly desirable. 

Funding

Open Access funding enabled and organized by Projekt DEAL

German Research Foundation (DFG)

German Federal Ministry of Education and Research (BMBF, grant 01EO2106)

German Cancer Aid (Deutsche Krebshilfe)

Wilhelm Sander Foundation

Open Access Publication Fund of UKE (Universitätsklinikum Hamburg-Eppendorf) and DFG

History

Data Availability Statement

The datasets generated during the current study are available from the corresponding author on reasonable request after approval by the Ethics Committee of the Hamburg Medical Association

Comments

The original article is available at https://www.nature.com/

Published Citation

Kocheise L, EpCAM-positive circulating tumor cells and serum AFP levels predict outcome after curative resection of hepatocellular carcinoma. Sci Rep. 2023;13(1):20827.

Publication Date

27 November 2023

PubMed ID

38012205

Department/Unit

  • Irish Centre for Vascular Biology
  • School of Pharmacy and Biomolecular Sciences

Publisher

Springer Nature Limited

Version

  • Published Version (Version of Record)