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An immune function assay predicts post-transplant recurrence in patients with hepatocellular carcinoma

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Abstract

Purpose

An immune function assay has been proposed as a new strategy to monitor immunosuppression after organ transplantation. However, there are limited data regarding its role in liver transplant recipients with hepatocellular carcinoma (HCC). In this study, we sought to determine the utility of this functional assay in assessing the risk of infection, rejection, and tumor recurrence in liver transplant recipients.

Methods

Immune function was determined by ImmuKnow assay that measures the amount of adenosine triphosphate (ATP) produced by CD4 (+) T cells to monitor the global immune status in 342 whole blood samples from 105 liver transplant recipients. The association between ATP value and post-transplant tumor recurrence was evaluated in 60 HCC patients. The ATP value in predicting tumor recurrence in other independent cohort of 92 recipients with HCC was analyzed prospectively.

Results

The mean ATP values of liver transplant recipients with infection (145.2 ± 87.0 ng/ml) or acute rejection (418.9 ± 169.5 ng/ml) were different from those with stable state (286.6 ± 143.9 ng/ml, P < 0.05). In recipients with HCC who developed recurrent tumors, the values were significantly lower than those without recurrence (137.8 ± 66.4 vs. 289 ± 133.9 ng/ml, P < 0.01); the optimal threshold value to predict post-transplant tumor recurrence was 175 ng/ml. Comparing with the patients in lower immune group (ATP ≤ 175 ng/ml), patients in the higher immune group (ATP > 175 ng/ml) experienced significantly better disease-free survival (P < 0.01). Multivariate Cox regression analysis showed the ATP value was an independent predictor of HCC recurrence.

Conclusions

The immune function assay has the potential to assess the risk of infection and rejection in liver transplantation and to predict post-transplant tumor recurrence in recipients with HCC.

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Acknowledgments

This work is supported by State 863 High Technology R&D Project of China (2007AA02Z479), National Natural Science Foundation of China (30972949), Shanghai Key-Tech Research & Development Program (09411951700), Doctoral Program of Higher Education of China (20090071110022), and National Key Sci-Tech Special Project of China (2008ZX10002-025).

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Authors and Affiliations

  1. Department of Liver Surgery, Liver Cancer Institute, Key Laboratory of Carcinogenesis and Cancer Invasion of Ministry of Education, Zhongshan Hospital, Fudan University, 180 FengLin Road, Shanghai, 200032, China

    Jian-Wen Cheng, Ying-Hong Shi, Jia Fan, Xiao-Wu Huang, Shuang-Jian Qiu, Yong-Sheng Xiao, Zheng Wang, Zhao-You Tang & Jian Zhou

  2. Shanghai Key Laboratory of Organ Transplantation, Shanghai, 200032, China

    Jian-Wen Cheng, Jia Fan, Xiao-Wu Huang, Yong-Sheng Xiao, Zheng Wang, Zhi Dai, Zhao-You Tang & Jian Zhou

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  1. Jian-Wen Cheng
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  2. Ying-Hong Shi
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  3. Jia Fan
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Correspondence to Jian Zhou.

Additional information

Jian-Wen Cheng, Ying-Hong Shi, and Jia Fan contributed equally to this work.

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Cheng, JW., Shi, YH., Fan, J. et al. An immune function assay predicts post-transplant recurrence in patients with hepatocellular carcinoma. J Cancer Res Clin Oncol 137, 1445–1453 (2011). https://doi.org/10.1007/s00432-011-1014-0

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  • DOI: https://doi.org/10.1007/s00432-011-1014-0

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