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Prognostic Value of Preoperative Serum Leucine Aminopeptidases in Hepatocellular Carcinoma Patients Who Underwent Liver Transplantation

Authors Ren Q, Fu S, Wang D, Ju W, He X

Received 14 November 2020

Accepted for publication 8 January 2021

Published 5 February 2021 Volume 2021:13 Pages 1053—1066

DOI https://doi.org/10.2147/CMAR.S292128

Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 3

Editor who approved publication: Dr Ahmet Emre Eşkazan


Qingqi Ren,1,* Shunjun Fu,2,* Dongping Wang,3– 5 Weiqiang Ju,3– 5 Xiaoshun He3– 5

1Department of Hepatobiliary and Pancreatic Surgery, Peking University Shenzhen Hospital, Shenzhen, People’s Republic of China; 2Department of Hepatobiliary Surgery, Zhujiang Hospital, Southern Medical University, Guangzhou, People’s Republic of China; 3Organ Transplant Center, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, People’s Republic of China; 4Guangdong Provincial Key Laboratory of Organ Donation and Transplant Immunology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, People’s Republic of China; 5Guangdong Provincial International Cooperation Base of Science and Technology (Organ Transplantation), The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, People’s Republic of China

*These authors contributed equally to this work

Correspondence: Xiaoshun He; Weiqiang Ju
Organ Transplant Center, The First Affiliated Hospital, Sun Yat-sen University, No. 58, ZhongShan Road II, Yuexiu, Guangzhou, 510080 Guangdong, People’s Republic of China
Email gdtrc@163.com; weiqiangju@163.com

Background: Leucine aminopeptidases (LAPs) have been reported to be involved in tumor cell proliferation, invasion and angiogenesis. However, the relationship between serum leucine aminopeptidases and prognosis of hepatocellular carcinoma (HCC) patients who underwent liver transplantation (LT) was not yet reported. We aimed to evaluate the prognostic value of preoperative serum leucine aminopeptidases in these patients.
Methods: Clinical data of 106 HCC patients who underwent LT were retrospectively analyzed. The sex ratio, age, HBV infection, Child–Pugh stage, preoperative tumor therapy, AFP, the largest tumor size, tumor number, Edmondson grading, macro- and micro-vascular invasion of patients with different serum LAP level and compositions of patients who met the criteria of Milan, UCSF or Hangzhou were compared using the chi-square test. The Kaplan–Meier method was performed in survival analysis and the log rank test was used in survival comparison.
Results: Serum LAPs were correlated with alpha-fetoprotein (AFP), the largest tumor size, tumor number and macro-vascular invasion. Patients with serum LAPs > 87 U/L showed significantly poorer disease-free survival (DFS) and overall survival (OS) than those with serum LAPs ≤ 87 U/L. Univariate analysis indicated that serum LAPs, AFP, the largest tumor size, tumor number, and macro- and micro-vascular invasion were all associated with DFS and OS. Multivariate analysis showed that serum LAPs, macro-vascular invasion and the largest tumor size were independently correlated with DFS and OS. Serum LAPs could also distinguish prognosis between patients with different status of AFP, the largest tumor size, tumor number, and macro- and micro-vascular invasion, as well as patients within and beyond selection criteria, such as Milan, University of California, San Francisco and Hangzhou criteria.
Conclusion: Elevated preoperative serum LAPs were associated with advanced tumor stage and aggressive biological behavior, and thus a poor outcome, which could be a prognostic marker for HCC patients who underwent LT.

Keywords: leucine aminopeptidases, hepatocellular carcinoma, liver transplantation, disease-free survival, overall survival

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