Chen Cong, Liu Jian, Gu Zhuxin, Sun Yanjun, Lu Wenwu, Liu Xiaokan, Chen Kang, Ma Tianzhi, Zhao Suming, Zhao Hui
Department of Interventional & Vascular Surgery, Affiliated Hospital of Nantong University, Nantong, 226001, People's Republic of China.
Dalian Medical University and Affiliated Hospital of Nantong University, Nantong, 226001, People's Republic of China.
J Hepatocell Carcinoma. 2023 Aug 8;10:1295-1308. doi: 10.2147/JHC.S423129. eCollection 2023.
Hepatocellular carcinoma (HCC) is one of the most lethal malignancies in the world. Patients with HCC choose postoperative adjuvant transarterial chemoembolization (PA-TACE) after surgical resection to reduce the risk of recurrence. However, many of them have recurrence within a short period.
In this retrospective analysis, a total of 173 patients who underwent PA-TACE between September 2016 and March 2020 were recruited. Radiomic features were derived from the arterial and venous phases of each patient. Early recurrence (ER)-related radiomics features of HCC and the spleen were selected to build two rad-scores using the least absolute shrinkage and selection operator (LASSO) Cox regression analysis. Logistic regression was applied to establish the Radiation (Rad)_score by combining the two regions. We constructed a nomogram containing clinical information and dual-region rad-scores, which was evaluated in terms of discrimination, calibration, and clinical usefulness.
All three radiological scores showed good performance for ER prediction. The combined Rad_score performed the best, with an area under the curve (AUC) of 0.853 (95% confidence interval [CI], 0.783-0.908) in the training set and 0.929 (95% CI, 0.789-0.988) in the validation set. Multivariate analysis identified total bilirubin (TBIL) and the combined Rad_score as independent prognostic factors for ER. The nomogram was found to be clinically valuable, as determined by the decision curves (DCA) and clinical impact curves (CIC).
A multimodal dual-region radiomics model combining HCC and the spleen is an independent prognostic tool for ER. The combination of dual-region radiomics features and clinicopathological factors has a good clinical application value.
肝细胞癌（HCC）是全球最致命的恶性肿瘤之一。HCC患者在手术切除后选择术后辅助经动脉化疗栓塞术（PA-TACE）以降低复发风险。然而，其中许多患者在短期内复发。
在这项回顾性分析中，共纳入了2016年9月至2020年3月期间接受PA-TACE的173例患者。从每位患者的动脉期和静脉期提取影像组学特征。选择HCC和脾脏的早期复发（ER）相关影像组学特征，使用最小绝对收缩和选择算子（LASSO）Cox回归分析构建两个影像组学评分。应用逻辑回归通过合并两个区域来建立放射（Rad）评分。我们构建了一个包含临床信息和双区域影像组学评分的列线图，并对其判别能力、校准度和临床实用性进行了评估。
所有三个放射学评分在ER预测方面均表现良好。联合Rad评分表现最佳，在训练集中曲线下面积（AUC）为0.853（95%置信区间[CI]，0.783-0.908），在验证集中为0.929（95%CI，0.789-0.988）。多变量分析确定总胆红素（TBIL）和联合Rad评分是ER的独立预后因素。通过决策曲线（DCA）和临床影响曲线（CIC）确定，列线图具有临床价值。
结合HCC和脾脏的多模态双区域影像组学模型是ER的独立预后工具。双区域影像组学特征与临床病理因素的结合具有良好的临床应用价值。
