Alpha-fetoprotein combined with initial tumor shape irregularity in predicting the survival of patients with advanced hepatocellular carcinoma treated with immune-checkpoint inhibitors: a retrospective multi-center cohort study.
Feng Zhang, Yong-Shuai Wang, Shao-Peng Li, Bin Zhao, Nan Huang, Rui-Peng Song, Fan-Zheng Meng, Zhi-Wen Feng, Shen-Yu Zhang, Hua-Chuan Song, Xiao-Peng Chen, Lian-Xin Liu, Ji-Zhou Wang
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引用次数: 0
Abstract
Background: Immune checkpoint inhibitors (ICIs) are playing a significant role in the treatment of hepatocellular carcinoma (HCC). This study aims to explore the prognostic value of alpha-fetoprotein (AFP) and initial tumor shape irregularity in patients treated with ICIs.
Methods: In this retrospective, multi-center study, 296 HCC patients were randomly divided into the training set and the validation set in a 3:2 ratio. The training set was used to evaluate prognostic factors and to develop an easily applicable ATSI (AFP and Tumor Shape Irregularity) score, which was verified in the validation set.
Results: The ATSI score was developed from two independent prognostic risk factors: baseline AFP ≥ 400 ng/ml (HR 1.73, 95% CI 1.01-2.96, P = 0.046) and initial tumor shape irregularity (HR 1.94, 95% CI 1.03-3.65, P = 0.041). The median overall survival (OS) was not reached (95% CI 28.20-NA) in patients who met no criteria (0 points), 25.8 months (95% CI 14.17-NA) in patients who met one criterion (1 point), and 17.03 months (95% CI 11.73-23.83) in patients who met two criteria (2 points) (P = 0.001). The median progression-free survival (PFS) was 10.83 months (95% CI 9.27-14.33) for 0 points, 8.03 months (95% CI 6.77-10.57) for 1 point, and 5.03 months (95% CI 3.83-9.67) for 2 points (P < 0.001). The validation set effectively verified these results (median OS, 37.43/24.27/14.03 months for 0/1/2 points, P = 0.028; median PFS, 13.93/8.30/4.90 months for 0/1/2 points, P < 0.001).
Conclusions: The ATSI score can effectively predict prognosis in HCC patients receiving ICIs.
背景：免疫检查点抑制剂（ICIs）在肝细胞癌（HCC）的治疗中发挥着重要作用。本研究旨在探讨甲胎蛋白（AFP）和初始肿瘤形状不规则在脑内注射（ICIs）患者中的预后价值。方法：采用回顾性、多中心研究，将296例HCC患者按3:2的比例随机分为训练组和验证组。该训练集用于评估预后因素，并制定易于应用的ATSI （AFP和肿瘤形状不规则性）评分，并在验证集中进行验证。结果：ATSI评分由两个独立的预后危险因素确定：基线AFP≥400 ng/ml （HR 1.73, 95% CI 1.01-2.96, P = 0.046）和初始肿瘤形状不规则（HR 1.94, 95% CI 1.03-3.65, P = 0.041）。不符合标准（0分）的患者的中位总生存期（OS）未达到（95% CI 28.20-NA），满足一个标准（1分）的患者的中位总生存期（OS）为25.8个月（95% CI 14.17-NA），满足两个标准（2分）的患者的中位总生存期（OS）为17.03个月（95% CI 11.73-23.83） （P = 0.001）。0分的中位无进展生存期（PFS）为10.83个月（95% CI 9.27 ~ 14.33）， 1分的中位无进展生存期为8.03个月（95% CI 6.77 ~ 10.57）， 2分的中位无进展生存期为5.03个月（95% CI 3.83 ~ 9.67）。(P)结论：ATSI评分可有效预测肝细胞癌接受ICIs患者的预后。
期刊介绍：
The Journal of Gastroenterology, which is the official publication of the Japanese Society of Gastroenterology, publishes Original Articles (Alimentary Tract/Liver, Pancreas, and Biliary Tract), Review Articles, Letters to the Editors and other articles on all aspects of the field of gastroenterology. Significant contributions relating to basic research, theory, and practice are welcomed. These publications are designed to disseminate knowledge in this field to a worldwide audience, and accordingly, its editorial board has an international membership.
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