Kuwano Akifumi, Yada Masayoshi, Miyazaki Yoshiko, Tanaka Kosuke, Koga Yuta, Ohishi Yoshihiro, Masumoto Akihide, Motomura Kenta
Department of Hepatology, Aso Iizuka Hospital, Iizuka, Japan.
Department of Diagnostic Pathology, Aso Iizuka Hospital, Iizuka, Japan.
Cancer Diagn Progn. 2023 Jul 3;3(4):468-474. doi: 10.21873/cdp.10241. eCollection 2023 Jul-Aug.
BACKGROUND/AIM: Systemic chemotherapy with atezolizumab plus bevacizumab is approved for unresectable hepatocellular carcinoma (HCC). It is necessary to identify probable predictive biomarkers for chemotherapies. HCC with rim arterial-phase enhancement (APHE) has been linked to aggressive tumor activity.
We studied the efficacy of atezolizumab plus bevacizumab for HCC using computed tomography (CT) or magnetic resonance imaging (MRI) imaging features. In total, 51 HCC patients who underwent CT or MRI were classified by the feature of rim APHE.
Clinical responses to chemotherapy were evaluated, and among those who received atezolizumab plus bevacizumab, there were 10 (19.6%) patients with rim APHE and 41 (80.4%) patients without rim APHE. We found that patients with rim APHE had a better response than those without rim APHE, and patients with rim APHE had longer median progression-free survival compared with those without rim APHE (p=0.026). Furthermore, liver tumor biopsy showed that HCC with rim APHE had a higher proportion of CD8+ tumor-infiltrating lymphocytes (p<0.01).
Rim APHE in CT/MRI imaging might be a noninvasive biomarker for predicting response to atezolizumab plus bevacizumab.
背景/目的：阿替利珠单抗联合贝伐单抗的全身化疗已被批准用于不可切除的肝细胞癌（HCC）。确定化疗可能的预测生物标志物很有必要。边缘动脉期强化（APHE）的HCC与侵袭性肿瘤活动有关。
我们利用计算机断层扫描（CT）或磁共振成像（MRI）成像特征研究了阿替利珠单抗联合贝伐单抗治疗HCC的疗效。总共51例接受CT或MRI检查的HCC患者根据边缘APHE特征进行了分类。
评估了化疗的临床反应，在接受阿替利珠单抗联合贝伐单抗治疗的患者中，有10例（19.6%）有边缘APHE，41例（80.4%）无边缘APHE。我们发现有边缘APHE的患者比无边缘APHE的患者反应更好，有边缘APHE的患者中位无进展生存期比无边缘APHE的患者更长（p=0.026）。此外，肝脏肿瘤活检显示，有边缘APHE的HCC中CD8+肿瘤浸润淋巴细胞比例更高（p<0.01）。
CT/MRI成像中的边缘APHE可能是预测阿替利珠单抗联合贝伐单抗反应的一种非侵入性生物标志物。
