CTC/CTM在肝癌肝移植中的应用前景

Application of CTC and CTM in liver transplantation for hepatocellular carcinoma

为优化完善肝移植受体的筛选标准,完善供体分配体系,降低肝癌肝移植患者的复发转移率,提高肝癌肝移植患者的生存期,有必要深入地研究评估肝癌肝移植患者的肿瘤生物学特性,筛选准确预测肝癌肝移植的预后指标,研究移植术后患者的免疫状态与肿瘤复发转移的关系,进而对高危复发风险患者进行有效的干预治疗,并对复发转移个体化进行综合治疗。CTC/CTM与恶性肿瘤的复发转移密切相关,有证据提示其与肝癌术后复发转移的相关性高于肿瘤大小、数目,血管侵犯等因素。因此对拟行肝移植的受体术前动态评估CTC/CTM可以作为筛选肝癌移植受体及预测受体复发转移的关键指标。

Hepatocellular carcinoma （HCC） is one of the most common malignancies in the world. For all the advances in urgical techniques, including transplantation, no substantial improvement has been made in the curative effect of HCC. The 1-year urvival rate of the HCC patients with recurrence after liver transplantation is only 18%. In order to optimize the screening criteria for ransplant recipients, perfect the distribution system of the donor, reduce the recurrence rate and improve the survival of the patients, t is necessary to gain a deeper insight into the tumor biological characteristics of the patients undergoing liver transplantation, precisely ~redict their prognostic indexes, and ascertain the relationship of post-transplant recurrence and metastasis with the patient＇s immune tatus, so as to carry out effective intervention for high-risk patients and individualized and integrated treatment for those with recur- ence or metastasis. Evidence shows that circulating tumor ceils （CTC） and circulating tumor microemboli （CTM） are closely related ~ith and contribute even more than other factors, such as the tumor size, tumor number, and vascular invasion, to the postoperative re- urrence and metastasis of HCC. Therefore, a dynamic evaluation of CTC and CTM before liver transplantation can provide essential in- licators for screening the recipient and predicting postoperative recurrence and metastasis.