Detection and analysis of circulating tumor cells in liquid biopsy from patients with liver tranplantation

Aksoy S., Aksoy F., Dündar H. Z., Mutlu M., Tekin Ç., Tunca B., ...More

55th Congress of the European Society for Surgical Research, Innsbruck, Austria, 10 - 11 December 2020, pp.95

  • Publication Type: Conference Paper / Summary Text
  • City: Innsbruck
  • Country: Austria
  • Page Numbers: pp.95
  • Bursa Uludag University Affiliated: Yes


Aim: Liquid biopsies refers to a multitude of minimally invasive techniques, providing the molecular signature of tumors with a single blood aspiration and without the need of applying invasive techniques. Circulating tumor cells (CTC) is a liquid biopsy biomarker that provides information for the molecular alterations of the tumor, and it has shown great promise in the clinical setting. Liver transplantation is the best treatment option for hepatocellular carcinoma (HCC), but it faces the problem of scarcity of donors and the risk of tumor recurrence, which affects between 15% and 20% of the cases, despite the use of restrictive criteria. This study aimed to determine if the number of CTC and changes in their numbers affected tumor recurrence and metastasis after surgical resection in patients with HCC. 

Methods: A total of 24 patients with HCC were evaluated from 2008 to 2017. CTCs were counted 24 hours prior to and 30 days after surgical excision of HCC using the CellSearch system. Furthermore, isolated-CTCs were analyzed genetic alterations using next-generation sequencing (NGS). 

Results: We found a total of 6 different mutations in samples from liquid biopsies using NGS. The most frequent mutations were found in TP53 (26%) and KRAS (14%). Numbers of CTCs (cutoff value: 4, per 5 ml peripheral blood) were signicantly associated with recurrence (P = 0.014). However, there were no signicant associations between other tested clinicopathological factors and CTC counts. Receiver operating characteristic curve analysis showed that pre/postoperative changes in the CTC count (<=4) were a better predictor of performance than absolute count. 

Conclusion: These results demonstrate that postoperative CTC counts (<=4) and changes in CTC counts may be independent prognostic indicators for PFS in patients withHCC, with the change in number of CTCs showing better predictive performance.