通过预处理磁共振成像特征预测孤立性小肝癌的术后预后:根据甲胎蛋白表达进行亚组分析。

IF 4.7 2区 医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING
European Radiology Pub Date : 2025-10-01 Epub Date: 2025-04-11 DOI:10.1007/s00330-025-11558-5
Wenlong Song, Yang Xu, Jun Zhou, Jiayi Yu, Xiaojing He, Caiming Jiang, Dajing Guo
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引用次数: 0

摘要

目的:建立包括MRI特征在内的模型,根据甲胎蛋白(AFP)表达预测单纯性小肝癌(SHCC)患者治愈性切除后的无复发生存期(RFS),并实现风险分层。材料与方法:回顾性纳入201例经病理诊断并行MRI检查的孤立性SHCC患者,分为afp阴性组(n = 85)和afp阳性组(n = 116)。通过单因素和多因素Cox分析确定与RFS相关的临床病理因素、影像学特征和几何参数。采用多变量Cox比例风险模型建立预测术后RFS的两种预后模型,采用一致性指数(C-index)评价其区分能力并进行内部验证。采用Kaplan-Meier分析,以RFS为终点评价模型的性能。结果:afp阴性SHCC RFS的预测因子包括马赛克结构、门静脉期肿瘤-右竖脊肌信号强度比和球形度,而afp阳性SHCC RFS的预测因子包括肝硬化、肿瘤生长亚型和非球形度。预测afp阴性和afp阳性SHCC患者RFS的c指数分别为0.700和0.717。结论:我们的两种预后模型可以帮助医生对afp阴性或afp阳性的孤立性shcc患者进行风险分层和复发监测。本研究根据甲胎蛋白表达水平探讨小肝癌患者术后预后的预测因素。结果MRI预处理和几何特征可作为预测不同甲胎蛋白表达的小肝癌术后无复发生存的预后指标。我们的模型指导临床医生对不同甲胎蛋白表达的小肝癌患者进行适当的治疗决策和实施适当的术后监测方案。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Predicting postresection outcomes in solitary small hepatocellular carcinoma via pretreatment MR imaging features: subgroup analysis according to alpha-fetoprotein expression.

Objectives: To develop models including MRI features for predicting recurrence-free survival (RFS) in patients with solitary small hepatocellular carcinoma (SHCC) following curative resection according to alpha-fetoprotein (AFP) expression and for achieving risk stratification.

Materials and methods: A total of 201 solitary SHCC patients diagnosed pathologically who underwent MRI were enrolled retrospectively and divided into AFP-negative (n = 85) and AFP-positive (n = 116) SHCC groups. Clinicopathological factors, imaging features, and geometric parameters associated with RFS were determined by univariate and multivariate Cox analyses. Two prognostic models predicting postresection RFS were developed by multivariate Cox proportional hazard model, and their discriminatory ability was evaluated by the concordance index (C-index) and conducted internal validation. Kaplan‒Meier analysis with RFS as the endpoint was used to assess model performance.

Results: The predictors of RFS in AFP-negative SHCC included mosaic architecture, portal-venous phase tumor-to-right erector spinae muscle signal intensity ratio, and sphericity, whereas those in AFP-positive SHCC were liver cirrhosis, tumor growth subtype, and asphericity. The C-indexes of the models in predicting RFS in AFP-negative and AFP-positive SHCC were 0.700 and 0.717, respectively. The risk probability calculated with the models stratified the two patient subgroups into two risk groups with significantly different survival outcomes (p < 0.001).

Conclusion: Our two prognostic models may assist physicians in stratifying risk and monitoring relapses in patients with AFP-negative or AFP-positive solitary SHCCs.

Key points: Question This study explored the predictors of the postresection outcomes of patients with small hepatocellular carcinoma according to the level of alpha-fetoprotein expression. Findings Pretreatment MRI and geometric features can serve as prognostic markers for predicting postoperative recurrence-free survival of small hepatocellular carcinoma with different alpha-fetoprotein expression. Clinical relevance Our models guide clinicians in administering appropriate therapeutic decisions and implementing proper postoperative monitoring regimens in different alpha-fetoprotein expression small hepatocellular carcinoma patients.

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来源期刊
European Radiology
European Radiology 医学-核医学
CiteScore
11.60
自引率
8.50%
发文量
874
审稿时长
2-4 weeks
期刊介绍: European Radiology (ER) continuously updates scientific knowledge in radiology by publication of strong original articles and state-of-the-art reviews written by leading radiologists. A well balanced combination of review articles, original papers, short communications from European radiological congresses and information on society matters makes ER an indispensable source for current information in this field. This is the Journal of the European Society of Radiology, and the official journal of a number of societies. From 2004-2008 supplements to European Radiology were published under its companion, European Radiology Supplements, ISSN 1613-3749.
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