Zhou Cheng, Zhang Xin, Zhou Kaiqian, Hou Yingyong, Chen Feiyu, Zhang Xiangyu, Ji Yuan, Qiu Shuangjian, Fan Jia, Zhou Jian, Zhou Yuhong, Wang Zheng
Liver Cancer Institute, Zhongshan Hospital, Fudan University, Shanghai, China.
Key Laboratory of Carcinogenesis and Cancer Invasion, Ministry of Education, Fudan University, Shanghai, China.
Ann Transl Med. 2022 Apr;10(7):394. doi: 10.21037/atm-21-4322.
Characterized by spindle cell composition in hepatocellular carcinoma tumor, sarcomatoid hepatocellular carcinoma (SHC) is a rare malignant with poor prognosis. In this study, we aimed to evaluate the clinical and pathological features of SHC and establish a nomogram that can predict long-term outcomes of the disease.
We retrospectively analyzed 63 patients who were diagnosed with SHC between October 2007 and November 2016 and used immunohistochemistry (IHC) to assessed various markers in liver samples. The clinical data and the histological and pathological findings were collected and used to build a nomogram to predict survival.
The median overall survival (OS) and the recurrence-free survival (RFS) in SHC were 23.2 and 8.4 months, respectively. High expression levels of tyrosine-protein kinase Met (17/63, 27.0%) were associated with poorer RFS (P=0.040). A panel of markers, consisting heat-shock protein 70 (HSP70), glutamine synthetase (GS), and glypican-3 (GPC3), merged as an independent risk factor for treatment outcomes. The nomogram, which including this panel of markers, predicted OS times with a concordance-index (C-index) score of 0.758 (95% CI: 0.672-0.843) in the training set and 0.832 (95% CI: 0.712-0.952) in the validation set. The use of the nomogram showed marked improvements in the prediction of patient outcomes compared with conventional staging systems (P<0.05).
Diagnosis of SHC is rare and has a relatively poor prognosis. A panel of markers HSP70, GS and GPC3 served as an independent prognostic factor for SHC.
肉瘤样肝细胞癌（SHC）以肝细胞癌肿瘤中的梭形细胞成分为特征，是一种预后较差的罕见恶性肿瘤。在本研究中，我们旨在评估SHC的临床和病理特征，并建立一个能预测该疾病长期预后的列线图。
我们回顾性分析了2007年10月至2016年11月期间诊断为SHC的63例患者，并使用免疫组织化学（IHC）评估肝脏样本中的各种标志物。收集临床数据以及组织学和病理学发现，并用于构建预测生存的列线图。
SHC的中位总生存期（OS）和无复发生存期（RFS）分别为23.2个月和8.4个月。酪氨酸蛋白激酶Met的高表达水平（17/63，27.0%）与较差的RFS相关（P=0.040）。一组由热休克蛋白70（HSP70）、谷氨酰胺合成酶（GS）和磷脂酰肌醇蛋白聚糖-3（GPC3）组成的标志物合并为治疗结果的独立危险因素。包含该标志物组的列线图在训练集中预测OS时间的一致性指数（C-index）评分为0.758（95%CI：0.672-0.843），在验证集中为0.832（95%CI：0.712-0.952）。与传统分期系统相比，使用列线图在预测患者预后方面有显著改善（P<0.05）。
SHC的诊断罕见且预后相对较差。一组标志物HSP70、GS和GPC3是SHC的独立预后因素。
