评估肝脏免疫状态指数在预测肝细胞癌患者术后预后方面的功效:一项多机构回顾性研究

IF 3.2 3区 医学 Q2 GASTROENTEROLOGY & HEPATOLOGY
Yuki Imaoka, Masahiro Ohira, Tsuyoshi Kobayashi, Naruhiko Honmyo, Michinori Hamaoka, Takashi Onoe, Daisuke Takei, Koichi Oishi, Tomoyuki Abe, Toshihiro Nakayama, Miho Akabane, Kazunari Sasaki, Hideki Ohdan
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引用次数: 0

摘要

背景:肝细胞癌(HCC)在全球癌症相关死亡中排名第三。尽管治疗取得了进展,但肝切除术后的高复发率(RR),尤其是肝纤维化和丙型肝炎病毒感染,仍然是一项挑战。影响预后的关键因素包括血管侵犯和围手术期失血,从而影响肝外复发。自然杀伤(NK)细胞是通过 TRAIL 介导的途径对抗循环肿瘤细胞的关键。本研究旨在验证肝脏免疫状态指数(LISI)作为肝脏NK细胞抗肿瘤效率预测工具的有效性,尤其是在有血管侵犯的HCC患者中:方法:广岛临床肿瘤学外科研究小组(HiSCO)对 1337 例原发性 HCC 肝切除术进行了回顾性分析。临床人口学数据来自电子病历。预后指数(FIB-4、ALBI、ALICE、GNRI、APRI 和 LISI)采用接收者操作特征曲线下面积值进行评估。生存分析采用卡普兰-梅耶估计和对数秩检验:结果:LISI与其他预后指标有明显的相关性,并将患者分为具有不同总生存期(OS)和RR的风险组。LISI对2年OS和RR的预测能力更强,尤其是对有血管侵犯的患者。随着时间的延长,APRI 和 FIB-4 指数的可靠性也有所提高。HISCO-HCC评分结合了LISI、肿瘤负荷评分和甲胎蛋白水平,提高了预后准确性:结论:LISI优于现有模型,尤其是在有血管侵犯的HCC中。HISCO-HCC评分提高了预后的准确性,为HCC的免疫治疗策略和患者个体化治疗提供了指导。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Evaluation of prognostic efficacy of liver immune status index in predicting postoperative outcomes in hepatocellular carcinoma patients: A multi-institutional retrospective study.

Background: Hepatocellular carcinoma (HCC) ranks third in cancer-related deaths globally. Despite treatment advances, high post-hepatectomy recurrence rates (RR), especially with liver fibrosis and hepatitis C virus infection, remain challenging. Key prognostic factors include vascular invasion and perioperative blood loss, impacting extrahepatic recurrence. Natural killer (NK) cells are crucial in countering circulating tumor cells through TRAIL-mediated pathways. The aim of this study was to validate the liver immune status index (LISI) as a predictive tool for liver NK cell antitumor efficiency, particularly in HCC patients with vascular invasion.

Methods: A retrospective analysis of 1337 primary HCC hepatectomies was conducted by the Hiroshima Surgical Study Group of Clinical Oncology (HiSCO). Clinicodemographic data were extracted from electronic medical records. Prognostic indices (FIB-4, ALBI, ALICE, GNRI, APRI, and LISI) were evaluated using area under the receiver operating characteristic curve values. Survival analyses employed Kaplan-Meier estimations and log-rank tests.

Results: LISI significantly correlated with other prognostic markers and stratified patients into risk groups with distinct overall survival (OS) and RR. It showed superior predictive performance for 2-year OS and RR, especially in patients with vascular invasion. Over longer periods, APRI and FIB-4 index reliabilities improved. The HISCO-HCC score, combining LISI, tumor burden score, and alpha-fetoprotein levels, enhanced prognostic accuracy.

Conclusion: LISI outperformed existing models, particularly in HCC with vascular invasion. The HISCO-HCC score offers improved prognostic precision, guiding immunotherapeutic strategies and individualized patient care in HCC.

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来源期刊
Journal of Hepato‐Biliary‐Pancreatic Sciences
Journal of Hepato‐Biliary‐Pancreatic Sciences GASTROENTEROLOGY & HEPATOLOGY-SURGERY
自引率
10.00%
发文量
178
审稿时长
6-12 weeks
期刊介绍: The Journal of Hepato-Biliary-Pancreatic Sciences (JHBPS) is the leading peer-reviewed journal in the field of hepato-biliary-pancreatic sciences. JHBPS publishes articles dealing with clinical research as well as translational research on all aspects of this field. Coverage includes Original Article, Review Article, Images of Interest, Rapid Communication and an announcement section. Letters to the Editor and comments on the journal’s policies or content are also included. JHBPS welcomes submissions from surgeons, physicians, endoscopists, radiologists, oncologists, and pathologists.
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