CCL26 as a prognostic biomarker in hepatocellular carcinoma: integrating bioinformatics analysis, clinical validation, and radiomics score.

BACKGROUND

CCL26 has been identified as a potential prognostic biomarker in hepatocellular carcinoma (HCC). This study aimed to assess the prognostic significance of CCL26 and develop a radiomics score (Rad-score) for predicting outcomes in HCC patients.

METHODS

Data from 316 HCC patients, including genomic information, computed tomography (CT) images, and clinicopathological data, were analyzed. The prognostic value of CCL26 was evaluated in 295 TCGA patients using Kaplan-Meier and Cox regression analyses, and validated in 21 patients from Jiujiang No. 1 People's Hospital. Gene set variation and immune cell infiltration analyses were conducted to elucidate the biological functions of CCL26. Radiomic models for predicting CCL26 expression were constructed using CT images and genomic data from 34 TCGA patients. Radiomic features were extracted from tumor regions and screened using maximum relevance minimum redundancy (mRMR) and recursive feature elimination (RFE). Two Rad-scores were generated via logistic regression and validated using internal fivefold cross-validation. A prognostic nomogram incorporating the optimal Rad-score, gender, and hepatic inflammation was developed using Cox proportional hazards regression.

RESULTS

Elevated CCL26 levels correlated with poor prognosis, as confirmed by immunohistochemistry. The optimal Rad-score, combined with gender and hepatic inflammation, accurately predicted overall survival (OS), with areas under the receiver operating characteristic curve (AUCs) of 0.819, 0.902, and 0.982 for 24-, 36-, and 48 month survival, respectively. Calibration curves and decision curve analysis (DCA) demonstrated the accuracy and clinical utility of the model.

CONCLUSIONS

CCL26 serves as a significant prognostic biomarker in HCC. The developed Rad-score provides an effective, non-invasive tool for predicting patient outcomes and enhancing clinical decision-making. This study not only highlights the prognostic role of CCL26 but also offers a novel approach for evaluating HCC patient prognosis through radiomics.