Journal of Hepatocellular Carcinoma最新文献

{"title":"Prediction Model of Survival in Unresectable HCC with Central Bile Duct Invasion Receiving TACE After Biliary Drainage: TEMP Score.","authors":"Wenzhe Fan, Xinlin Zheng, Weihong Zhang, Bowen Zhu, Yanqin Wu, Miao Xue, Rong Tang, Zhen Huang, Liangliang Qiao, Mingjian Lu, Jian Wu, Yiyang Tang, Jinghua Chen, Shugui Huang, Mingjun Bai, Jiaping Li","doi":"10.2147/JHC.S505328","DOIUrl":"10.2147/JHC.S505328","url":null,"abstract":"<p><strong>Purpose: </strong>Central bile duct invasion (BDI) by hepatocellular carcinoma (HCC) is rare and associated with poor prognosis, lacking treatment guidelines. While transarterial chemoembolization (TACE) is often used for unresectable cases, determining optimal candidates post-biliary drainage is controversial. We aim to develop a prognostic prediction model for unresectable HCC (uHCC) patients with central BDI receiving sequential TACE after successful biliary drainage.</p><p><strong>Patients and methods: </strong>We retrospectively analyzed 267 uHCC patients with central BDI receiving successful biliary drainage and sequential TACE from seven tertiary centers (2015-2021), divided into training (n=187) and validation (n=80) sets. Using Cox proportional-hazards regression model, we identified key prognostic indicators for overall survival (OS) and constructed a prediction model.</p><p><strong>Results: </strong>Pre-TACE total bilirubin (TBil) values, extrahepatic spread (EHS), multiple intrahepatic tumors (MIT), and portal vein tumor thrombus (PVTT) were identified as the significant clinical indicators for OS. These four parameters were included in a novel prediction model, named TEMP score, which could successfully categorize patients in the training set into three distinct risk grades with median OS of 26.9, 9.4, and 5.8 months, respectively. The TEMP score predicted the time-dependent areas under the receiver operating characteristic curves for OS at 6 months, 1 year, and 2 years of 0.813/0.907, 0.833/0.782, and 0.838/0.811 in the training and validation sets, with corresponding C-indices of 0.812/0.929, 0.829/0.761, and 0.818/0.791, respectively, outperforming other currently available models in both cohorts. The calibration curve of the model for predicting OS presented good consistency between observations and predictions in both the training set and validation set.</p><p><strong>Conclusion: </strong>The TEMP score effectively stratifies the prognosis of uHCC patients with central BDI who have undergone successful bile drainage and sequential TACE, helping to identify those who may benefit from TACE treatment.</p>","PeriodicalId":15906,"journal":{"name":"Journal of Hepatocellular Carcinoma","volume":"12 ","pages":"615-628"},"PeriodicalIF":4.2,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11932117/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143700660","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Combined TACE with Targeted and Immunotherapy versus TACE Alone Improves DFS in HCC with MVI: A Multicenter Propensity Score Matching Study.","authors":"Xiaokun Chen, Xiangan Wu, Wei Peng, Liguo Liu, Xiao Liu, Xueshuai Wan, Haifeng Xu, Yongchang Zheng, Haitao Zhao, Yilei Mao, Xin Lu, Xinting Sang, Xiaoyan Chang, Kang Zhou, Jie Pan, Mei Guan, Dandan Hu, Haidong Tan, Yaojun Zhang, Shunda Du","doi":"10.2147/JHC.S504016","DOIUrl":"10.2147/JHC.S504016","url":null,"abstract":"<p><strong>Background: </strong>Hepatocellular carcinoma (HCC) with microvascular invasion (MVI) is associated with high recurrence and poor survival outcomes. Although adjuvant therapies such as transcatheter arterial chemoembolization (TACE), targeted therapy, and immunotherapy show potential in improving outcomes, the optimal postoperative treatment strategy remains undetermined. This study evaluates the efficacy of different adjuvant treatments on disease-free survival (DFS) and overall survival (OS) in HCC patients with MVI following curative resection.</p><p><strong>Methods: </strong>A retrospective cohort of 409 HCC patients with MVI who underwent curative resection from three clinical centers between 2017 and 2024 was analyzed. Patients were stratified into three groups: TACE alone (n=132), TACE + targeted therapy (n=58), and TACE + targeted immunotherapy (n=68). Propensity score matching (PSM) was employed to balance confounding factors. Kaplan-Meier survival curves and Cox regression models were used to assess DFS and OS. A nomogram was constructed for individualized DFS prediction.</p><p><strong>Results: </strong>After PSM, both the TACE + targeted therapy and TACE + targeted immunotherapy groups exhibited significantly prolonged DFS compared to TACE alone (median DFS: 16 vs 22 and 21 months, respectively; p=0.027). No significant differences were observed in OS across the groups. The nomogram for DFS demonstrated robust predictive performance, with a C-index of 0.709 and 0.645 in the training and validation cohorts, respectively, supporting its utility in clinical decision-making.</p><p><strong>Conclusion: </strong>In HCC patients with MVI, adjuvant TACE combined with targeted therapy or targeted immunotherapy significantly enhances DFS, though no OS benefit was observed. The developed nomogram provides a reliable tool for risk stratification and personalized postoperative management in this high-risk patient population.</p>","PeriodicalId":15906,"journal":{"name":"Journal of Hepatocellular Carcinoma","volume":"12 ","pages":"561-577"},"PeriodicalIF":4.2,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11930282/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143692239","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Study on the Mechanism of QRICH1 Mediating PRMT1 to Regulate the Arginine Methylation Modification of cGAS to Promote Arsenics-Induced Pyroptosis in Hepatocellular Carcinoma Cells.","authors":"Jiayuan Zhang, Tian Tian, Shanshan Tian, Jinhai Yao, Yingwan Zhang, Rujia Xie, Ting Yang, Bing Han","doi":"10.2147/JHC.S505266","DOIUrl":"10.2147/JHC.S505266","url":null,"abstract":"<p><strong>Purpose: </strong>This study aims to investigate the mechanism of action of arsenic-based agents against hepatocellular carcinoma (HCC) and to identify effective drug targets for HCC treatment.</p><p><strong>Methods: </strong>Huh7 and HepG2 cells treated with NaAsO2 were assessed for cell viability, pyroptosis, migration, and invasion after undergoing lentiviral transfection. An orthotopic liver tumor model was established and divided into a model group and a treatment group. Proteins associated with QRICH1, PRMT1, cGAS-STING, and the classical pyroptosis pathway were quantified using Western blotting. The intracellular expression and localization of PRMT1 and NLRP3 in HCC were analyzed through cellular immunofluorescence. Co-immunoprecipitation (Co-IP) was performed to examine the protein interactions between PRMT1 and cGAS, as well as between STING and NLRP3. Chromatin immunoprecipitation (ChIP) was used to confirm QRICH1 enrichment in the PRMT1 promoter region.</p><p><strong>Results: </strong>NaAsO2 treatment significantly inhibited the proliferation of Huh7 and HepG2 cells and effectively blocked their migration and invasion capabilities, while promoting cellular pyroptosis. Quantitative polymerase chain reaction(QRCR) and ChIP assays confirmed that NaAsO2 regulates PRMT1 expression by down-regulate QRICH1 binding in the PRMT1 promoter region. Additionally, NaAsO2 decreased the expression of the QRICH1-PRMT1 complex and upregulated the cGAS-STING signaling pathway, activating the downstream NLRP3-dependent classical pyroptosis pathway. Overexpression of QRICH1 reversed these effects.</p><p><strong>Conclusion: </strong>NaAsO2 inhibits the expression of the QRICH1-PRMT1 axis, activates cGAS-STING signaling pathway transduction, and induces pyroptosis in HCC cells, thereby increasing the infiltration of immune cells in liver cancer tissues.</p>","PeriodicalId":15906,"journal":{"name":"Journal of Hepatocellular Carcinoma","volume":"12 ","pages":"597-614"},"PeriodicalIF":4.2,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11930257/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143692368","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Radiation Segmentectomy or Ablative External Beam Radiation Therapy as Initial Treatment for Solitary Hepatocellular Carcinoma: A Multicenter Experience.","authors":"Cynthia De la Garza-Ramos, S Ali Montazeri, Jordan D LeGout, Andrew R Lewis, Gregory T Frey, Ricardo Paz-Fumagalli, Christopher L Hallemeier, Michael S Rutenberg, Jonathan B Ashman, Beau B Toskich","doi":"10.2147/JHC.S507267","DOIUrl":"10.2147/JHC.S507267","url":null,"abstract":"<p><strong>Purpose: </strong>Radiation segmentectomy (RS) and ablative external beam radiation therapy (EBRT) are now accepted, definitive, local therapies for hepatocellular carcinoma (HCC). This report aimed to describe the clinical outcomes of RS and EBRT for treatment-naïve, solitary, HCC.</p><p><strong>Methods: </strong>A multicenter retrospective review was performed of all patients treated with RS or EBRT from March 2016 through September 2023. Inclusion criteria were initial treatment for solitary HCC ≤8 cm and absence of macrovascular invasion or extrahepatic disease. Outcomes were censored for liver transplantation (LT).</p><p><strong>Results: </strong>Eighty-six patients (RS: 58; EBRT: 28) met inclusion criteria. The EBRT cohort had older patients (median 76 vs 66 years, p < 0.001), larger tumors (median 3.7 vs 2.4 cm, p < 0.001), and worse performance status (p = 0.02). The RS cohort had more patients with ≥ grade 3 liver fibrosis (p < 0.001). Radiologic complete response (rCR) was achieved in 97% of RS and 82% of EBRT patients (p = 0.02). Median time to rCR was 1 month (95% CI: 0.9-1.1) after RS and 7 months (95% CI: 6-7) after EBRT (p < 0.001). The 1-year local control was 97% vs 93% for RS and EBRT, respectively (p = 0.80). Subsequent LT was performed in 48% of RS and 11% of EBRT patients with tumor complete pathologic response rates of 76% (n=22/28) and 33% (n=1/3), respectively. Progression free survival at 1-year was 87% after RS vs 80% after EBRT (p = 0.26). 1- and 2-year overall survival was 88% and 85% after RS vs 84% and 59% after EBRT (p = 0.34).</p><p><strong>Conclusion: </strong>RS and EBRT are effective therapies for solitary HCC. Treatment should be determined via multidisciplinary discussion based on individual patient characteristics.</p>","PeriodicalId":15906,"journal":{"name":"Journal of Hepatocellular Carcinoma","volume":"12 ","pages":"553-559"},"PeriodicalIF":4.2,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11912899/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143649254","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lasso-Based Nomogram for Predicting Early Recurrence Following Radical Resection in Hepatocellular Carcinoma.","authors":"Guoqun Zheng, Minjie Zheng, Peng Hu, Yu Zhu, Wenlong Zhang, Fabiao Zhang","doi":"10.2147/JHC.S510581","DOIUrl":"10.2147/JHC.S510581","url":null,"abstract":"<p><strong>Background: </strong>Hepatocellular carcinoma (HCC) is a common malignancy with a high recurrence rate following curative resection. This study aimed to identify factors contributing to early recurrence (within 2 years) and develop a Lasso-based nomogram for individualized risk assessment.</p><p><strong>Methods: </strong>We conducted a retrospective analysis of 206 hCC patients who underwent curative resection at Taizhou Hospital, Zhejiang Province, from January 2019 to August 2022. Patients were randomly divided into training (n=144) and validation (n=62) cohorts. Lasso regression was used to identify potential recurrence risk factors among 17 candidate predictors. A Cox proportional hazards model was constructed based on variables selected by Lasso. Model performance was assessed using receiver operating characteristic (ROC) curves, calibration plots, and decision curve analysis (DCA).</p><p><strong>Results: </strong>Five independent predictors of early HCC recurrence were identified: age, serum alanine aminotransferase (ALT) levels, cirrhosis, tumor diameter, and microvascular invasion (MVI). The nomogram demonstrated area under the curve (AUC) values for recurrence-free survival (RFS) of 0.828 (95% confidence interval [CI]: 0.753-0.904) at 1 year, 0.799 (95% CI: 0.718-0.880) at 2 years, and 0.742 (95% CI: 0.642-0.842) at 5 years in the training cohort. The corresponding AUCs in the validation cohort were 0.823 (95% CI: 0.686-0.960), 0.804 (95% CI: 0.686-0.922), and 0.857 (95% CI: 0.722-0.992) at 1, 2 and 5 years, respectively. Calibration curves and DCA confirmed the nomogram's high accuracy and clinical utility.</p><p><strong>Conclusion: </strong>The Lasso-Cox regression nomogram effectively predicts HCC recurrence within two years post-hepatectomy, providing a valuable tool for personalized postoperative management to improve patient outcomes.</p>","PeriodicalId":15906,"journal":{"name":"Journal of Hepatocellular Carcinoma","volume":"12 ","pages":"539-552"},"PeriodicalIF":4.2,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11911823/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143649239","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy and Safety of Ipilimumab Plus Anti-PD-1/PD-L1 Antibodies Combination Therapy in Advanced Hepatocellular Carcinoma Patients Progressing After Multiple Lines of Treatment: A Retrospective Multicenter Study.","authors":"Su-Su Zheng, Jing-Fang Wu, Zhen-Zhen Zhang, Yan-Fang Wu, Yi-Jie Chen, Sheng Qian, Bo-Heng Zhang","doi":"10.2147/JHC.S512302","DOIUrl":"https://doi.org/10.2147/JHC.S512302","url":null,"abstract":"<p><strong>Background: </strong>The combination of nivolumab and ipilimumab has demonstrated significant antitumor activity in first-line treatment for hepatocellular carcinoma (HCC) and in second-line treatment following progression on sorafenib. However, the efficacy and safety of ipilimumab plus anti-PD-1/PD-L1 antibodies combination therapy in advanced HCC patients who have progressed after multiple lines of treatment have not yet been reported.</p><p><strong>Materials and methods: </strong>We conducted a multicenter retrospective study that included 33 HCC patients who had progressed after multiple lines of immune-targeted therapy and received ipilimumab combination therapy. All patients had received at least one line of immunotherapy based combination therapy (excluding those treated with anti-CTLA-4 inhibitors). The primary endpoints were overall survival (OS) and progression-free survival (PFS). Efficacy was assessed using RECIST 1.1, while adverse events were evaluated according to the Common Terminology Criteria for Adverse Events version 5.0 (CTCAE 5.0).</p><p><strong>Results: </strong>Among the patients, 29 (87.9%) received ipilimumab combination therapy as third-line or later line therapy. The median OS for the entire cohort was 14.07 months (95% CI: 5.57 months - not evaluable), and the median PFS was 2.36 months (95% CI: 1.97-5.64 months). Univariate survival analysis indicated that an NLR ≥ 3.1 and tumor size ≥ 63 mm are prognostic risk factors for OS (P=0.03 and P=0.027, respectively). Multivariate survival analysis revealed that an NLR ≥ 3.1 is the only independent prognostic risk factor for OS (P=0.048). The overall response rate (ORR) was 12.1%, and the disease control rate (DCR) was 48.5%. One patient experienced treatment-related death (3%), two had hyperprogression (6.1%), and three discontinued treatment due to adverse events (9.1%).</p><p><strong>Conclusion: </strong>Ipilimumab combination therapy in very late lines is a viable treatment option, although careful monitoring for adverse events is essential. Earlier application of this combination may potentially benefit patients more effectively.</p>","PeriodicalId":15906,"journal":{"name":"Journal of Hepatocellular Carcinoma","volume":"12 ","pages":"527-537"},"PeriodicalIF":4.2,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11910043/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143649235","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Diagnostic Performance of AFP, AFP-L3, DCP, CA199, and Their Combination for Primary Liver Cancer.","authors":"Yue Liu, Wenrong Jiang, Xiangxiao Li, Hu Zhao, Shiwen Wang","doi":"10.2147/JHC.S499966","DOIUrl":"10.2147/JHC.S499966","url":null,"abstract":"<p><strong>Purpose: </strong>The prevalence of primary liver cancer (PLC) is rising, yet strategies for its early diagnosis remain inadequate. This study aims to identify novel biomarkers to improve the diagnostic ability of PLC.</p><p><strong>Patients and methods: </strong>This study included 94 patients with PLC, 128 patients with benign liver disease (BLD), and 79 normal controls (NC) were included. Among the PLC group, there were 39 patients with hepatocellular carcinoma (HCC), 14 patients with intrahepatic cholangiocarcinoma (ICC), 4 patients with combined hepatocellular-cholangiocarcinoma (CHC) and 37 patients with imaging-diagnosed HCC, respectively. Serum biomarkers and other laboratory parameters were collected and analyzed. Diagnostic values of individual and combined biomarkers for PLC were assessed using receiver operating characteristic (ROC) curve analysis. Univariate and multivariate logistic regression identified predictors of PLC, and a nomogram model was developed based on the independent predictors.</p><p><strong>Results: </strong>AFP and DCP levels were significantly higher in the HCC patients compared to those with the BLD. AFP-L3 and CA199 levels were markedly elevated in patients with HCC, ICC, and CHC compared with the other groups. Combining AFP, AFP-L3, DCP, and CA199 increased the AUC to 0.8492 for the PLC group versus the BLD group. Multivariate logistic regression analysis identified sex, AFP-L3, DCP, and CA199 as independent predictors of PLC, and a reliable nomogram model was developed based on these predictors.</p><p><strong>Conclusion: </strong>The combined use of AFP, AFP-L3, DCP, and CA199 significantly enhanced the diagnostic performance of PLC compared with existing models like GALAD (gender, age, AFP, AFP-L3, and DCP), and ASAP (age, sex, AFP, DCP), as well as individual biomarkers.</p>","PeriodicalId":15906,"journal":{"name":"Journal of Hepatocellular Carcinoma","volume":"12 ","pages":"513-526"},"PeriodicalIF":4.2,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11892369/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143597217","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Improving Health-Related Quality of Life in Hepatocellular Carcinoma Patients: Key Methodologies for Assessing Patient Reported Outcomes and Intervention Targets.","authors":"Andrew M Moon, Michael D Kappelman, A Sidney Barritt Iv, Donna M Evon, Hanna K Sanoff, Lynne I Wagner","doi":"10.2147/JHC.S347929","DOIUrl":"10.2147/JHC.S347929","url":null,"abstract":"<p><p>Hepatocellular carcinoma (HCC) is a complex cancer that generally arises in the context of cirrhosis. Patients with HCC have symptom burden and impact on health-related quality of life (HRQOL) resulting from underlying liver disease, HCC, and cancer treatments. Patient-reported outcome (PRO) measures may improve the management of patients with HCC by accurately capturing the patient perspective, informing prognosis, guiding treatment decisions, and supporting symptom based and palliative care. Furthermore, PRO use in HCC research could enhance patient-focused therapy development. This review focuses on the clinical and research assessment of PROs among patients with HCC.</p>","PeriodicalId":15906,"journal":{"name":"Journal of Hepatocellular Carcinoma","volume":"12 ","pages":"497-511"},"PeriodicalIF":4.2,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11891488/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143597215","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prognostic Value of Changes in Combined Child-Pugh Class and ALBI Grade in Hepatocellular Carcinoma Treated with Transcatheter Intra-Arterial Therapy Plus Targeted Therapy and PD-(L)1 Inhibitors.","authors":"Xiaoyu Huang, Xiaojing Cao, Yaqing Kong, Fan Tang, Tianhao Cong, Xiang Zhou","doi":"10.2147/JHC.S490439","DOIUrl":"10.2147/JHC.S490439","url":null,"abstract":"<p><strong>Purpose: </strong>This study aims to investigate liver function changes in hepatocellular carcinoma (HCC) patients treated with transcatheter intra-arterial therapy plus molecular targeted agents and programmed cell death-1 (ligand-1) inhibitors, and evaluate the prognostic significance of the combination of Child-Pugh (CP) class and albumin-bilirubin (ALBI) grade (CP/ALBI).</p><p><strong>Methods: </strong>This is a retrospective study. A total of 149 patients from 2019 to 2023 in China were included. Changes in CP score, ALBI grade, and CP/ALBI grade at 4-8 weeks, 12-16 weeks, and 20-28 weeks post-treatment was evaluated. Cox regression models identified prognostic factors for overall survival (OS) and progression-free survival (PFS). The discrimination of the scoring systems was determined by concordance index (C-index) and time-dependent area under the receiver operating characteristic curve (AUC).</p><p><strong>Results: </strong>Among CP-A patients (n = 137), 11.68% (n = 16) progressed to CP-B by 20-28 weeks (<i>p</i> < 0.001). Multivariate analysis identified CP/ALBI grade at 20-28 weeks as an independent prognostic factor for OS (grade 2 vs grade 1, hazard ratio [HR] 3.12, <i>p</i> < 0.001; grade 3 vs grade 1, HR 4.95, <i>p</i> < 0.001) and at 4-8 weeks for PFS (grade 3 vs grade 1, HR 3.26, <i>p</i> = 0.002). The combination of CP/ALBI grade and baseline clinical prognostic factors (Eastern Cooperative Oncology Group Performance Status, Barcelona Clinic Liver Cancer stage, tumor size) demonstrated superior discrimination for OS (C-index: 0.74-0.77; time-dependent AUC: 0.74-0.92). Baseline factors associated with maintaining CP/ALBI grade 1 in CP-A patients included ALBI grade 1 (odds ratio [OR] 3.09, <i>p</i> = 0.030) and aspartate aminotransferase < 40 U/L (OR 3.35, <i>p</i> = 0.017).</p><p><strong>Conclusion: </strong>A small but notable proportion of HCC patients experienced liver function deterioration within 28-week of combined treatment. Dynamic monitoring of CP/ALBI grade provides valuable prognostic insights for patient stratification.</p>","PeriodicalId":15906,"journal":{"name":"Journal of Hepatocellular Carcinoma","volume":"12 ","pages":"481-496"},"PeriodicalIF":4.2,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11890011/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143584825","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Research Progress of Liver Cancer Recurrence Based on Energy Metabolism of Liver Cancer Stem Cells.","authors":"Mingming Wu, Huayu Wang, Xiangxiang Wu, Huahui Zeng, Mingsan Miao, Yagang Song","doi":"10.2147/JHC.S500638","DOIUrl":"10.2147/JHC.S500638","url":null,"abstract":"<p><strong>Objective: </strong>The aim of this study is to investigate the recurrence and progression of liver cancer by focusing on the energy metabolism of liver cancer stem cells.</p><p><strong>Methods: </strong>A comprehensive literature search was conducted using databases including CNKI, PubMed, Wanfang, and Citexs to analyze the etiology and treatment of hepatocellular carcinoma (HCC), the factors and mechanisms contributing to HCC recurrence, and the impact of energy metabolism in HCC stem cells on the development of HCC. Furthermore, the association between HCC recurrence and the energy metabolism of HCC stem cells was examined.</p><p><strong>Results: </strong>The primary targets associated with the glycolytic metabolism of HCC stem cells included HK2, PFK, PK, LDH, among others. Glutamine metabolism primarily involves the tricarboxylic acid (TCA) cycle, with main targets such as mTORC1 and reactive oxygen species (ROS). The principal pathway in lipid metabolism is fatty acid (FA) biosynthesis, with key targets being fatty acid synthase (FASN), acetyl-coenzyme A carboxylase (ACC), stearoyl-coenzyme A desaturase-1 (SCD1), and adenosine monophosphate-activated protein kinase (AMPK). Targets in the oxidative phosphorylation pathway include PGC1a. Finally, key targets in iron metabolism encompass System Xc, glutathione peroxidase 4 (GPX4), and DMT1.</p><p><strong>Conclusion: </strong>The glycolytic metabolism of HCC stem cells represents a primary metabolic pathway in HCC stem cells, with key targets including HK2, PFK, PK, and LDH warranting closer attention. Glutamine metabolism should focus on the TCA cycle and targets such as mTORC1 and ROS. Lipid metabolism pathway involves FA biosynthesis, with significant targets being FASN, ACC, SCD1, and AMPK. Iron metabolism, specifically System Xc, GPX4, and DMT1 targets, should be carefully considered. Therefore, interventions for the prevention and treatment of liver cancer recurrence should be directed towards these aspects of liver cancer stem cells.</p>","PeriodicalId":15906,"journal":{"name":"Journal of Hepatocellular Carcinoma","volume":"12 ","pages":"467-480"},"PeriodicalIF":4.2,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11887506/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143585249","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}