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24 April 2019 : Original article  

Role of Allelic Imbalance in Predicting Hepatocellular Carcinoma (HCC) Recurrence Risk After Liver Transplant

Duilio Pagano1ABCDEF, Floriana Barbera2BD, Pier Giulio Conaldi23AFG, Aurelio Seidita1BD, Fabrizio Di Francesco1BF, Daniele Di Carlo1B, Marco Bàrbara1CD, Fabio Tuzzolino4CD, Angelo Luca5AG, Salvatore Gruttadauria1AF*

DOI: 10.12659/AOT.913692

Ann Transplant 2019; 24:223-233

Abstract

BACKGROUND: One of the most controversial problems for liver transplantation in patients affected by hepatocellular carcinoma (HCC) remains the lack of an oncologic staging system to predict cancer recurrence after liver transplantation (LT). We analyzed allelic imbalance (AI) in 19 microsatellites, and assessed the post-LT HCC recurrence risk.

MATERIAL AND METHODS: Seventy-one patients were included; 18 had tumor recurrence within 5 years post-transplant. Molecular analysis was done in the primary HCC and peripheral blood samples: a total of 19 microsatellites was used to assess AI. Specific AI was evaluated when outside of range value between 0.66 and 1.5. Based on data in the literature, we grouped the 19 microsatellites into 4 panels. We calculated the fractional allelic imbalance (FAI) to make comparisons between different panels including different subsets of microsatellites.

RESULTS: We report that AI was associated with HCC recurrence in 3 main loci (D3S2303, D9S251, and D9S254). Tumor recurrence was associated only with 2 specific panels with 9 microsatellites previously reported to be associated with high risk for HCC recurrence. Our data show that fractional allelic imbalance (FAI) index has good negative ability to predict HCC recurrence (Panel 2: negative predictive value of 95%).

CONCLUSIONS: AI analysis could have prognostic value in risk management of HCC recurrence after LT, especially for early recurrence.

Keywords: Allelic Imbalance, Carcinoma, Hepatocellular, Liver Transplantation, Liver Neoplasms, Risk Factors

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Annals of Transplantation eISSN: 2329-0358
Annals of Transplantation eISSN: 2329-0358