Xu Xiao, Ling Qi, Wang Jianguo, Xie Haiyang, Wei Xuyong, Lu Di, Hu Qichao, Zhang Xuanyu, Wu Liming, Zhou Lin, Zheng Shusen
Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China.
Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Hangzhou, China.
Int J Cancer. 2016 Feb 1;138(3):620-9. doi: 10.1002/ijc.29821. Epub 2015 Sep 14.
Recurrence of hepatocellular carcinoma (HCC) is one of the leading causes of death after liver transplantation (LT). We aim to evaluate the association of donor and recipient single nucleotide polymorphisms (SNPs) with the risk of HCC recurrence after LT. A total of 155 adult patients who underwent primary LT for HCC were enrolled. Ten SNPs associated with HCC susceptibility were genotyped. Patients who received donor livers with the rs11614913 homozygous CC variant presented significantly higher recurrence rates of HCC (41.7 vs. 15.3%, p = 0.009) and lower cumulative tumor-free survival (p = 0.005) than those who received TT wild-type donor livers. The donor rs11614913 genetic variant was an independent risk factor for HCC recurrence (odds ratio = 2 per each C allele, p < 0.05) and could significantly improve the predictive abilities of clinical models (Milan, UCSF and Hangzhou criteria). Donor livers homozygous for rs11614913 CC were associated with a higher miR-196a expression than TT (p = 0.002). In a lentiviral infection of mouse liver and orthotopic mouse model of HCC, the liver miR-196a overexpression group showed a significantly larger tumor size than the control group (p = 0.001). There is a close association between the tumor size and expression of miR-196a in the liver (r = 0.693, p = 0.001). In conclusion, the donor miR-196a-2 rs11614913 polymorphism is associated with HCC recurrence after LT and improves the predictive value of clinical models. The overexpression of miR-196a in the liver might provide a tumor-favorable environment for the development of HCC.
肝细胞癌(HCC)复发是肝移植(LT)后主要的死亡原因之一。我们旨在评估供体和受体单核苷酸多态性(SNP)与LT后HCC复发风险之间的关联。共纳入155例因HCC接受初次LT的成年患者。对10个与HCC易感性相关的SNP进行基因分型。接受携带rs11614913纯合CC变异的供体肝脏的患者,其HCC复发率显著高于接受TT野生型供体肝脏的患者(41.7%对15.3%,p = 0.009),且累积无瘤生存率较低(p = 0.005)。供体rs11614913基因变异是HCC复发的独立危险因素(每个C等位基因的比值比 = 2,p < 0.05),并且可以显著提高临床模型(米兰、旧金山和杭州标准)的预测能力。rs11614913 CC纯合的供体肝脏与TT相比,miR - 196a表达更高(p = 0.002)。在小鼠肝脏的慢病毒感染和HCC原位小鼠模型中,肝脏miR - 196a过表达组的肿瘤大小显著大于对照组(p = 0.001)。肝脏中肿瘤大小与miR - 196a表达之间存在密切关联(r = 0.693,p = 0.001)。总之,供体miR - 196a - 2 rs11614913多态性与LT后HCC复发相关,并提高了临床模型的预测价值。肝脏中miR - 196a的过表达可能为HCC的发展提供了有利于肿瘤生长的环境。