mTOR Expression in Liver Transplant Candidates with Hepatocellular Carcinoma: Impact on Histological Features and Tumour Recurrence

• Published in: International journal of molecular sciences 2019-01, Vol.20 (2), p.336
• Main Authors: Guerrero, Marta, Ferrín, Gustavo, Rodríguez-Perálvarez, Manuel, González-Rubio, Sandra, Sánchez-Frías, Marina, Amado, Víctor, Pozo, Juan C, Poyato, Antonio, Ciria, Rubén, Ayllón, María D, Barrera, Pilar, Montero, José L, de la Mata, Manuel
• Format: Article
• Language: English
• Subjects: Cell proliferation; Cirrhosis; Clinical medicine; Clinical trials; Fatty liver; Graft rejection; Hemochromatosis; Hepatitis; Hepatitis B; Hepatocellular carcinoma; Immunosuppression; Immunosuppressive agents; Liver; Liver cancer; Liver cirrhosis; Liver diseases; liver transplantation; Liver transplants; Medical prognosis; mTOR; Nodules; Protein expression; Proteins; Rapamycin; Rejection; Risk groups; TOR protein; Transplantation; Transplants & implants; Tumors
• ISSN: 1422-0067; 1661-6596; 1422-0067
• DOI: 10.3390/ijms20020336

(1) Background: The mammalian target of rapamycin (mTOR) pathway activation is critical for hepatocellular carcinoma (HCC) progression. We aimed to evaluate the mTOR tissue expression in liver transplant (LT) patients and to analyse its influence on post-LT outcomes. (2) Methods: Prospective study including a cohort of HCC patients who underwent LT (2012⁻2015). MTOR pathway expression was evaluated in the explanted liver by using the "PathScan Intracellular Signalling Array Kit" (Cell Signalling). Kaplan-Meier and Cox regression analyses were performed to evaluate post-LT HCC recurrence. (3) Results: Forty-nine patients were included (average age 56.4 ± 6, 14.3% females). Phospho-mTOR (Ser2448) was over-expressed in peritumoral tissue as compared with tumoral tissue (ΔSignal 22.2%; < 0.001). The mTOR activators were also increased in peritumoral tissue (phospho-Akt (Thr308) ΔSignal 18.2%, = 0.004; phospho-AMPKa (Thr172) ΔSignal 56.3%, < 0.001), as they were the downstream effectors responsible for cell growth/survival (phospho-p70S6K (Thr389) ΔSignal 33.3%, < 0.001 and phospho-S6RP (Ser235/236) ΔSignal 54.6%, < 0.001). MTOR expression was increased in patients with multinodular HCC (tumoral = 0.01; peritumoral = 0.001). Increased phospho-mTOR in tumoral tissue was associated with higher HCC recurrence rates after LT (23.8% vs. 5.9% at 24 months, = 0.04). (4) Conclusion: mTOR pathway is over-expressed in patients with multinodular HCC and is it associated with increased post-LT tumour recurrence rates.