一种新型基于缺氧的放射性特征用于肝癌经动脉化疗栓塞术的初步鉴定。
Preliminary qualification of a novel, hypoxic-based radiologic signature for trans-arterial chemoembolization in hepatocellular carcinoma.
机构信息
Department of Surgery and Cancer, Imperial College London, Hammersmith Hospital, Du Cane Road, London, W120HS, UK.
Department of Hepatobiliary Surgery, Imperial College NHS Trust, Hammersmith Hospital, Du Cane Road, London, W120HS, UK.
出版信息
BMC Cancer. 2018 Feb 20;18(1):211. doi: 10.1186/s12885-018-4120-4.
BACKGROUND
Survival advantage following trans-arterial chemoembolization (TACE) is variable in patients with hepatocellular carcinoma (HCC). We combined pre-TACE radiologic features to derive a novel prognostic signature in HCC.
METHODS
A multi-institutional dataset of 98 patients was generated from two retrospective cohorts from United Kingdom (65%) and Italy (36%). The prognostic impact of a number baseline imaging parameters was assessed and factors significant on univariate analysis were combined to create a novel radiologic signature on multivariable analyses predictive of overall survival (OS) following TACE.
RESULTS
Median OS was 15.4 months. Tumour size > 7 cm (p < 0.001), intra-tumour necrosis (ITN) (p = 0.02) and arterial ectatic neovascularisation (AEN) (p = 0.03) emerged as individual prognostic factors together with radiologic response (p < 0.001) and elevated alpha-fetoprotein (AFP) (p = 0.01). Combination of tumour size > 7 cm, ITN and AEN identified patients with poor prognosis (p < 0.001).
CONCLUSIONS
We identified a coherent signature based on commonly available imaging biomarkers likely to be reflective of differential patterns of relative hypoxia and neovascularisation. Large tumours displaying AEN and ITN are characterised by a shorter survival after TACE.
背景
经动脉化疗栓塞（TACE）后肝癌（HCC）患者的生存优势各不相同。我们结合 TACE 前的影像学特征，得出了 HCC 的一种新的预后标志物。
方法
我们从英国（65%）和意大利（36%）的两个回顾性队列中生成了一个包含 98 名患者的多机构数据集。评估了一系列基线影像学参数的预后影响，对单变量分析中有意义的因素进行了组合，以在多变量分析中创建一种新的影像学标志物，预测 TACE 后总体生存（OS）。
结果
中位 OS 为 15.4 个月。肿瘤大小＞7cm（p＜0.001）、肿瘤内坏死（ITN）（p＝0.02）和动脉扩张性新生血管（AEN）（p＝0.03）以及影像学反应（p＜0.001）和甲胎蛋白（AFP）升高（p＝0.01）是独立的预后因素。肿瘤大小＞7cm、ITN 和 AEN 的组合可识别出预后不良的患者（p＜0.001）。
结论
我们基于常见的可用影像学生物标志物确定了一个一致的标志物，该标志物可能反映了相对缺氧和新生血管形成的不同模式。表现为 AEN 和 ITN 的大肿瘤在 TACE 后生存时间较短。
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