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The Enhanced Role of Eosinophils in Radiomics-Based Diagnosis of Microvascular Invasion and Its Association with the Immune Microenvironment in Hepatocellular Carcinoma. 嗜酸性粒细胞在基于放射组学的肝细胞癌微血管侵犯诊断中的增强作用及其与免疫微环境的关联
IF 4.2 3区 医学 Q2 ONCOLOGY Pub Date : 2024-09-25 eCollection Date: 2024-01-01 DOI: 10.2147/JHC.S484027
Dong Liu, Jianmin Wu, Han Wang, Hui Dong, Lei Chen, Ningyang Jia

Objective: To investigate the role of eosinophil counts (EC) in microvascular invasion (MVI) for enhancing the radiomics based diagnostic model. Additionally, its correlation with early recurrence and tumor immune microenvironment was explored.

Methods: Propensity score matching was employed to evaluate on 462 cases whether EC was an independent risk factor for MVI. Subgroup analyses examined EC's effect on MVI across varying hypersplenism degrees. Univariate-multivariate logistic regression identified MVI's independent factors to develop a diagnostic model. Univariate-multivariate COX regression determined early recurrence factors. Co-detection by indexing (CODEX) constructed the immune score (IS), and Spearman correlation analyzed its association with peripheral immunity.

Results: EC was an independent risk factor for MVI (p=0.038, OR=1.304 (95% CI: 1.014-1.677)), and its effect on MVI disappeared with the severity of hypersplenism. The diagnostic model with EC was significantly improved (AUC=0.787 (95% CI: 0.737-0.836) vs AUC=0.748(95% CI: 0.694-0.802, p=0.005)). MVI was an independent risk factor for early recurrence (p<0.001, HR = 2.254 (95% CI: 1.557-3.263)). IS was negatively correlated with lymphocyte counts (R=-0.311, p=0.022), and positively correlated with EC (R=0.301, p=0.027) and RS (R = 0.315, p = 0.018).

Conclusion: EC was an independent risk factor for MVI and was related to the tumor immune microenvironment. EC should be included in the diagnosis of MVI to improve diagnostic efficiency.

目的研究嗜酸性粒细胞计数(EC)在微血管侵犯(MVI)中的作用,以加强基于放射组学的诊断模型。此外,还探讨其与早期复发和肿瘤免疫微环境的相关性:方法:对 462 个病例进行倾向评分匹配,以评估 EC 是否是 MVI 的独立风险因素。亚组分析研究了不同脾功能亢进程度的 EC 对 MVI 的影响。单变量-多变量逻辑回归确定了 MVI 的独立因素,从而建立了诊断模型。单变量-多变量 COX 回归确定了早期复发因素。通过指数化联合检测(CODEX)建立了免疫评分(IS),并通过斯皮尔曼相关性分析了其与外周免疫的关系:结果:EC是MVI的独立风险因素(P=0.038,OR=1.304(95% CI:1.014-1.677)),其对MVI的影响随脾功能亢进的严重程度而消失。EC的诊断模型明显改善(AUC=0.787(95% CI:0.737-0.836) vs AUC=0.748(95% CI:0.694-0.802,p=0.005))。MVI是早期复发的独立风险因素(pp=0.022),与EC(R=0.301,p=0.027)和RS(R=0.315,p=0.018)呈正相关:结论:EC是MVI的独立危险因素,与肿瘤免疫微环境有关。结论:EC是MVI的独立危险因素,与肿瘤免疫微环境有关,应将EC纳入MVI的诊断中,以提高诊断效率。
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引用次数: 0
Expression and Targeted Application of Claudins Family in Hepatobiliary and Pancreatic Diseases. 肝胆胰疾病中 Claudins 家族的表达和靶向应用
IF 4.2 3区 医学 Q2 ONCOLOGY Pub Date : 2024-09-25 eCollection Date: 2024-01-01 DOI: 10.2147/JHC.S483861
Fangqian Du, Yuwei Xie, Shengze Wu, Mengling Ji, Bingzi Dong, Chengzhan Zhu

Hepatobiliary and pancreatic diseases are becoming increasingly common worldwide and associated cancers are prone to recurrence and metastasis. For a more accurate treatment, new therapeutic strategies are urgently needed. The claudins (CLDN) family comprises a class of membrane proteins that are the main components of tight junctions, and are essential for forming intercellular barriers and maintaining cellular polarity. In mammals, the claudin family contains at least 27 transmembrane proteins and plays a major role in mediating cell adhesion and paracellular permeability. Multiple claudin proteins are altered in various cancers, including gastric cancer (GC), esophageal cancer (EC), hepatocellular carcinoma (HCC), pancreatic cancer (PC), colorectal cancer (CRC) and breast cancer (BC). An increasing number of studies have shown that claudins are closely associated with the occurrence and development of hepatobiliary and pancreatic diseases. Interestingly, claudin proteins exhibit different effects on cancer progression in different tumor tissues, including tumor suppression and promotion. In addition, various claudin proteins are currently being studied as potential diagnostic and therapeutic targets, including claudin-3, claudin-4, claudin-18.2, etc. In this article, the functional phenotype, molecular mechanism, and targeted application of the claudin family in hepatobiliary and pancreatic diseases are reviewed, with an emphasis on claudin-1, claudin-4, claudin-7 and claudin-18.2, and the current situation and future prospects are proposed.

肝胆胰疾病在全球范围内越来越常见,相关癌症容易复发和转移。为了更准确地治疗,迫切需要新的治疗策略。克劳丁蛋白(CLDN)家族由一类膜蛋白组成,它们是紧密连接的主要成分,对于形成细胞间屏障和维持细胞极性至关重要。在哺乳动物中,克劳丁家族包含至少 27 个跨膜蛋白,在介导细胞粘附和细胞旁通透性方面发挥着重要作用。多种克劳丁蛋白在各种癌症中发生改变,包括胃癌(GC)、食管癌(EC)、肝细胞癌(HCC)、胰腺癌(PC)、结直肠癌(CRC)和乳腺癌(BC)。越来越多的研究表明,克劳丁蛋白与肝胆胰疾病的发生和发展密切相关。有趣的是,在不同的肿瘤组织中,claudin 蛋白对癌症的进展表现出不同的作用,包括抑制和促进肿瘤。此外,目前正在研究多种claudin蛋白作为潜在的诊断和治疗靶点,包括claudin-3、claudin-4、claudin-18.2等。本文综述了claudin家族在肝胆胰疾病中的功能表型、分子机制和靶向应用,重点介绍了claudin-1、claudin-4、claudin-7和claudin-18.2,并提出了现状和未来展望。
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引用次数: 0
Impact of Duration of Adjuvant Therapy on Patients with Initially Unresectable Hepatocellular Carcinoma After Conversion Surgery: A Propensity Score Matching Study. 辅助治疗持续时间对转换手术后最初无法切除的肝细胞癌患者的影响:倾向得分匹配研究
IF 4.2 3区 医学 Q2 ONCOLOGY Pub Date : 2024-09-24 eCollection Date: 2024-01-01 DOI: 10.2147/JHC.S477019
Zhong-Tai Lin, Shao-Ming Wei, Jun-Yi Wu, Zhi-Bo Zhang, Shuang-Jia Wang, Jian-Yin Zhou, Meng-Chao Luo, Zhen-Xin Zeng, Xiang-Ye Ou, Yang-Kai Fu, Han Li, De-Yi Liu, Jia-Yi Wu, Mao-Lin Yan

Background: This study aimed to assess the effect of adjuvant therapy with different durations in patients with initially unresectable hepatocellular carcinoma (uHCC) after conversion surgery.

Methods: This study included 85 patients with initially uHCC who received conversion surgery between May 2019 and November 2022. They were divided into the long duration group (n = 57) and short duration group (n = 28) based on postoperative medication duration. Recurrence-free survival (RFS) and overall survival (OS) were analyzed and compared between the cohorts.

Results: No significant difference in RFS or OS was found between the two groups [RFS: hazard ratio (HR) = 0.486; 95% confidence interval (CI), 0.229-1.034, P = 0.061; OS: HR = 0.377; 95% CI, 0.119-1.196, P = 0.098]. Patients without major pathologic response (MPR) in the long duration group had better RFS and OS results compared to those in the short duration group (RFS: HR = 0.242; 95% CI, 0.092-0.634, P = 0.004; OS: HR = 0.264; 95% CI, 0.079-0.882, P = 0.031). No significant difference was detected in RFS or OS between the two groups in patients with MPR (RFS: HR = 1.250; 95% CI, 0.373-4.183, P = 0.718; OS: HR = 7.389; 95% CI, 0.147-372.4, P = 0.317). After propensity score matching, 25 pairs of patients were selected and the results remained consistent.

Conclusion: At least 6 months of adjuvant therapy may be beneficial for patients without MPR after conversion surgery. However, in patients with MPR, the effect of adjuvant therapy remains unclear. Further studies are needed to confirm the optimal duration of adjuvant therapy.

背景:本研究旨在评估不同持续时间的辅助治疗对转归手术后最初无法切除的肝细胞癌(uHCC)患者的影响:本研究旨在评估不同持续时间的辅助治疗对接受转化手术后最初无法切除的肝细胞癌(uHCC)患者的影响:本研究纳入了在2019年5月至2022年11月期间接受转化手术的85例初诊uHCC患者。根据术后用药时间长短,将他们分为长病程组(n = 57)和短病程组(n = 28)。对两组患者的无复发生存期(RFS)和总生存期(OS)进行分析和比较:结果:两组患者的无复发生存期(RFS)和总生存期(OS)无明显差异[RFS:危险比(HR)=0.486;95% 置信区间(CI),0.229-1.034,P=0.061;OS:危险比(HR)=0.377;95% 置信区间(CI),0.229-1.034,P=0.061]:HR = 0.377; 95% CI, 0.119-1.196, P = 0.098]。与疗程短组相比,疗程长组无主要病理反应(MPR)的患者的RFS和OS结果更好(RFS:HR = 0.242;95% CI,0.092-0.634,P = 0.004;OS:HR = 0.264;95% CI,0.119-1.196,P = 0.098]:HR = 0.264; 95% CI, 0.079-0.882, P = 0.031)。在MPR患者中,两组的RFS和OS均无明显差异(RFS:HR = 1.250;95% CI,0.373-4.183,P = 0.718;OS:HR = 7.389;95% CI,0.634,P = 0.004):HR = 7.389;95% CI,0.147-372.4,P = 0.317)。经过倾向评分匹配后,选择了25对患者,结果仍然一致:结论:至少 6 个月的辅助治疗可能对转换手术后无 MPR 的患者有益。然而,对于患有 MPR 的患者,辅助治疗的效果仍不明确。需要进一步研究来确定辅助治疗的最佳持续时间。
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引用次数: 0
ZDHHC20 Activates AKT Signaling Pathway to Promote Cell Proliferation in Hepatocellular Carcinoma ZDHHC20 激活 AKT 信号通路,促进肝细胞癌细胞增殖
IF 4.1 3区 医学 Q2 ONCOLOGY Pub Date : 2024-09-18 DOI: 10.2147/jhc.s457682
Xiaoju Huang, Mengmeng Wang, Dan Zhang, Junpeng Meng, Pian Liu
Background: Liver cancer is the sixth most common cancer worldwide, and hepatocellular carcinoma (HCC) presents one of the most challenging global health issues. ZDHHC20, a member of the ZDHHC palmitoyltransferase (ZDHHC-PAT) family, is involved in a reversible lipid modification known as palmitoylation, which contributes to the occurrence and progression of various tumors. However, the specific mechanisms underlying the involvement of ZDHHC20 in this process are unclear.
Methods: The effects of both ZDHHC20 knockdown and overexpression on hepatocellular carcinoma cell proliferation were evaluated using PCR, Western blotting, CCK-8 assay, colony formation assay, cell cycle analysis, apoptosis analysis, and EDU assay. The TCGA-LIHC dataset was analyzed bioinformatically, and the phosphorylation level of PI3K and AKT in SK-Hep1 and Huh7 cells was assessed using Western blotting. Nude mouse subcutaneous xenograft experiments were conducted to evaluate the effects of different treatment conditions on mouse tumor growth.
Results: ZDHHC20 knockdown inhibited cell proliferation and promoted apoptosis, while overexpression of ZDHHC20 promoted cell proliferation and inhibited apoptosis. Knockdown of ZDHHC20 also decreased phosphorylation of PI3K and AKT in HCC, whereas overexpression of ZDHHC20 increased phosphorylation of PI3K and AKT. The PI3K-AKT pathway inhibitors, LY294002 and MK2206, effectively inhibited the promotional effects of ZDHHC20 on the proliferation and growth of HCC.
Conclusion: High expression of ZDHHC20 promotes the proliferation and tumor growth of HCC by activating the PI3K-AKT signaling pathway. The PI3K inhibitor LY294002 and the AKT inhibitor MK2206 inhibit the promotional effects of ZDHHC20 on the proliferation of HCC and the growth of tumors.

背景:肝癌是全球第六大常见癌症,肝细胞癌(HCC)是全球最具挑战性的健康问题之一。ZDHHC20是ZDHHC棕榈酰基转移酶(ZDHHC-PAT)家族的成员,它参与了一种称为棕榈酰化的可逆脂质修饰,而棕榈酰化是导致各种肿瘤发生和发展的原因之一。然而,ZDHHC20参与这一过程的具体机制尚不清楚:方法:采用 PCR、Western 印迹、CCK-8 检测、集落形成检测、细胞周期分析、细胞凋亡分析和 EDU 检测等方法评估了 ZDHHC20 敲除和过表达对肝癌细胞增殖的影响。对TCGA-LIHC数据集进行了生物信息学分析,并使用Western印迹法评估了PI3K和AKT在SK-Hep1和Huh7细胞中的磷酸化水平。裸鼠皮下异种移植实验评估了不同处理条件对小鼠肿瘤生长的影响:结果:敲除 ZDHHC20 可抑制细胞增殖并促进细胞凋亡,而过表达 ZDHHC20 则可促进细胞增殖并抑制细胞凋亡。敲除 ZDHHC20 还会降低 HCC 中 PI3K 和 AKT 的磷酸化,而过表达 ZDHHC20 则会增加 PI3K 和 AKT 的磷酸化。PI3K-AKT通路抑制剂LY294002和MK2206能有效抑制ZDHHC20对HCC增殖和生长的促进作用:结论:ZDHHC20的高表达通过激活PI3K-AKT信号通路促进HCC的增殖和肿瘤生长。PI3K抑制剂LY294002和AKT抑制剂MK2206抑制了ZDHHC20对HCC增殖和肿瘤生长的促进作用。
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引用次数: 0
Dendritic Cell-Related Gene Signatures in Hepatocellular Carcinoma: An Analysis for Prognosis and Therapy Efficacy Evaluation 肝细胞癌中与树突状细胞相关的基因信号:预后和疗效评估分析
IF 4.1 3区 医学 Q2 ONCOLOGY Pub Date : 2024-09-17 DOI: 10.2147/jhc.s481338
Huasheng Huang, Shayong Peng, Yongguang Wei, Chenlu Lan, Wei Qin, Xiwen Liao, Cheng-Kun Yang, Guangzhi Zhu, Xin Zhou, Tao Peng
Background: This study aimed to identify dendritic cells (DCs) related genes in hepatocellular carcinoma (HCC) patients, establish DC-related subtypes and signatures, and correlate them with prognosis and treatment response.
Methods: DC-related genes were screened using Weighted Gene Co-expression Network Analysis (WGCNA) based on RNA sequencing from the TCGA (374 samples), GSE14520 (242 samples), and GSE76427 datasets (115 samples), following immune infiltration assessment by the TIME method. Two DC-related subtypes in HCC were identified through unsupervised clustering. A DC-related signature (DCRS) predictive of overall survival was constructed using LASSO and Cox regression models, and validated across the three datasets. Additionally, genetic mutation characteristics, immune infiltration levels, and treatment sensitivity were explored in DCRS risk groups. The expression levels of DCRS genes and risk scores were validated in the transcriptome of 13 HCC patients receiving combined targeted therapy and immunotherapy in the Guangxi cohort using Wilcoxon test.
Results: A signature consisting of 13 genes related to DCs was constructed, and the superior prognostic consistency of the low DCRS risk group was validated across the TCGA (P=0.003), GSE76427 (P=0.005), and GSE14520 (P=0.047) datasets. Furthermore, in the 147-sample transarterial chemoembolization (TACE) treatment dataset GSE104580, the response group exhibited lower risk scores than the non-response group (P=0.01), whereas in the 140-sample Sorafenib treatment dataset GSE109211 (P=0.041) and the 17-sample anti-PD-1 treatment dataset GSE202069 (P=0.027), the risk scores were higher in the response group. We also validated the gene expression levels of DCRS and the higher risk scores in the response group of the Guangxi cohort (P=0.034).
Conclusion: A DCRS consisting of 13 genes was established in HCC, facilitating the prediction of patient prognosis and responsiveness to TACE, targeted therapy, and immunotherapy.

背景:本研究旨在鉴定肝细胞癌(HCC)患者的树突状细胞(DCs)相关基因,建立DC相关亚型和特征,并将其与预后和治疗反应相关联:根据TCGA(374个样本)、GSE14520(242个样本)和GSE76427数据集(115个样本)中的RNA测序结果,采用加权基因共表达网络分析(WGCNA)筛选了DC相关基因,并采用TIME方法评估了免疫浸润情况。通过无监督聚类,确定了两种与 HCC 中 DC 相关的亚型。利用 LASSO 和 Cox 回归模型构建了可预测总生存期的 DC 相关特征(DCRS),并在三个数据集中进行了验证。此外,还探讨了DCRS风险组的基因突变特征、免疫浸润水平和治疗敏感性。在广西队列中接受联合靶向治疗和免疫治疗的13例HCC患者的转录组中,使用Wilcoxon检验验证了DCRS基因的表达水平和风险评分:结果:由13个与DCs相关的基因组成的特征被构建出来,低DCRS风险组的预后一致性在TCGA(P=0.003)、GSE76427(P=0.005)和GSE14520(P=0.047)数据集中得到了验证。此外,在147个样本的经动脉化疗栓塞(TACE)治疗数据集GSE104580中,应答组的风险评分低于非应答组(P=0.01),而在140个样本的索拉非尼治疗数据集GSE109211(P=0.041)和17个样本的抗PD-1治疗数据集GSE202069(P=0.027)中,应答组的风险评分更高。我们还验证了DCRS的基因表达水平和广西队列中应答组较高的风险评分(P=0.034):结论:在HCC中建立了由13个基因组成的DCRS,有助于预测患者的预后以及对TACE、靶向治疗和免疫治疗的反应性。
{"title":"Dendritic Cell-Related Gene Signatures in Hepatocellular Carcinoma: An Analysis for Prognosis and Therapy Efficacy Evaluation","authors":"Huasheng Huang, Shayong Peng, Yongguang Wei, Chenlu Lan, Wei Qin, Xiwen Liao, Cheng-Kun Yang, Guangzhi Zhu, Xin Zhou, Tao Peng","doi":"10.2147/jhc.s481338","DOIUrl":"https://doi.org/10.2147/jhc.s481338","url":null,"abstract":"<strong>Background:</strong> This study aimed to identify dendritic cells (DCs) related genes in hepatocellular carcinoma (HCC) patients, establish DC-related subtypes and signatures, and correlate them with prognosis and treatment response.<br/><strong>Methods:</strong> DC-related genes were screened using Weighted Gene Co-expression Network Analysis (WGCNA) based on RNA sequencing from the TCGA (374 samples), GSE14520 (242 samples), and GSE76427 datasets (115 samples), following immune infiltration assessment by the TIME method. Two DC-related subtypes in HCC were identified through unsupervised clustering. A DC-related signature (DCRS) predictive of overall survival was constructed using LASSO and Cox regression models, and validated across the three datasets. Additionally, genetic mutation characteristics, immune infiltration levels, and treatment sensitivity were explored in DCRS risk groups. The expression levels of DCRS genes and risk scores were validated in the transcriptome of 13 HCC patients receiving combined targeted therapy and immunotherapy in the Guangxi cohort using Wilcoxon test.<br/><strong>Results:</strong> A signature consisting of 13 genes related to DCs was constructed, and the superior prognostic consistency of the low DCRS risk group was validated across the TCGA (<em>P</em>=0.003), GSE76427 (<em>P</em>=0.005), and GSE14520 (<em>P</em>=0.047) datasets. Furthermore, in the 147-sample transarterial chemoembolization (TACE) treatment dataset GSE104580, the response group exhibited lower risk scores than the non-response group (<em>P</em>=0.01), whereas in the 140-sample Sorafenib treatment dataset GSE109211 (<em>P</em>=0.041) and the 17-sample anti-PD-1 treatment dataset GSE202069 (<em>P</em>=0.027), the risk scores were higher in the response group. We also validated the gene expression levels of DCRS and the higher risk scores in the response group of the Guangxi cohort (<em>P</em>=0.034).<br/><strong>Conclusion:</strong> A DCRS consisting of 13 genes was established in HCC, facilitating the prediction of patient prognosis and responsiveness to TACE, targeted therapy, and immunotherapy. <br/><br/>","PeriodicalId":15906,"journal":{"name":"Journal of Hepatocellular Carcinoma","volume":"11 1","pages":""},"PeriodicalIF":4.1,"publicationDate":"2024-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142250087","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Predicting Treatment Response and Prognosis in Patients with Hepatocellular Carcinoma after Interventional Therapy [Letter] 预测介入疗法后肝细胞癌患者的治疗反应和预后 [信]
IF 4.1 3区 医学 Q2 ONCOLOGY Pub Date : 2024-09-17 DOI: 10.2147/jhc.s494470
Hang Li, Xiping Shen, Ji Wu
Letter for the article An Oxidative Stress-Related Prognostic Signature Predicts Treatment Response and Outcomes for Hepatocellular Carcinoma After Transarterial Chemoembolization
致信《与氧化应激相关的预后特征可预测经动脉化疗栓塞术后肝细胞癌的治疗反应和疗效
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引用次数: 0
Hepatic Arterial Infusion Chemotherapy Combined Lenvatinib and PD-1 Inhibitor Showed Improved Survival for Infiltrative Hepatocellular Carcinoma: A Multicenter Cohort Study 肝动脉灌注化疗联合乐伐替尼和PD-1抑制剂可提高浸润性肝细胞癌的生存率:一项多中心队列研究
IF 4.1 3区 医学 Q2 ONCOLOGY Pub Date : 2024-09-09 DOI: 10.2147/jhc.s477872
Ruixia Li, Xiaohui Wang, Hui Li, Murong Wang, Juncheng Wang, Wei Wang, Qunfang Zhou
<strong>Purpose:</strong> Lenvatinib and programmed cell death protein-1 (PD-1) inhibitor on infiltrative hepatocellular carcinoma (HCC) have obtained demonstrated efficacy and still need improvement. Hepatic arterial infusion chemotherapy (HAIC) has shown promising results for advanced HCC. This study aimed to compare the efficacy of HAIC combined Lenvatinib and PD-1 inhibitor versus Lenvatinib combined PD-1 inhibitor for infiltrative HCC.<br/><strong>Patients and Methods:</strong> A total of 232 patients were enrolled. There were 114 patients received Lenvatinib combined PD-1 inhibitor (Len+PD-1 group) and 118 patients received HAIC combined Lenvatinib and PD-1 inhibitor (HAIC+Len+PD-1 group). Overall survival (OS), progression-free survival (PFS) and safety of patients were compared between the two groups by propensity score–matching (PSM).<br/><strong>Results:</strong> The 6-, 12-, and 24-month OS rates were 93.8%, 65.1% and 13.4% in Len+PD-1 group, and 100%, 77.3% and 32.1% in HAIC+Len+PD-1 group, respectively. The 3-, 6-, and 12-month PFS rates were 86.4%, 45.7% and 14.1% in Len+PD-1 group, and 95.1%, 59.3% and 25.9% in HAIC+Len+PD-1 group, respectively. The HAIC+Len+PD-1 group had obviously better survival than the Len+PD-1 group both in OS (P=0.002) and PFS (P=0.004). Subgroup analysis revealed that OS in patients with metastasis was improved with HAIC+Len+PD-1 treatment. Patients with alpha-fetoprotein (AFP) response after treatment showed better survival than the non-response. In addition, HAIC+Len+PD-1 group showed manageable adverse events (AEs).<br/><strong>Conclusion:</strong> Patient with infiltrative HCC, HAIC+Len+PD-1 treatment had longer OS and PFS than Len+PD-1 treatment. Early AFP response was an effective indicator of better survival and tumor response to therapy.<br/><br/><strong>Plain Language Summary:</strong> Infiltrative hepatocellular carcinoma (HCC) is an odd group that is not well adjudicated in the current staging systems, and treatment options for patients with infiltrative HCC are challenging with scant and insufficient clinical evidence. In this multi-center study, we innovatively analyzed the outcome of hepatic arterial infusion chemotherapy (HAIC) combined lenvatinib and PD-1 inhibitor (HAIC+Len+PD-1) was associated longer progression-free survival and overall survival than Lenvatinib plus PD-1 inhibitor combination (Len+PD-1) for patient with infiltrative HCC. In addition, further intragroup analysis revealed that OS of patients with and without metastasis in Len+PD-1 group was significant difference. However, no difference was observed in OS for patients with and without metastasis in HAIC+Len+PD-1 group. Patients with alpha-fetoprotein (AFP) response after treatment showed better survival than the non-response. Our research provides evidence that HAIC combined Lenvatinib and PD-1 inhibitor results in clinically significant improvements in infiltrative HCC. It could be recommended as a first choice for infiltr
目的:伦伐替尼和程序性细胞死亡蛋白-1(PD-1)抑制剂对浸润性肝细胞癌(HCC)有明显疗效,但仍需改进。肝动脉灌注化疗(HAIC)对晚期 HCC 有着良好的疗效。本研究旨在比较 HAIC 联合伦伐替尼和 PD-1 抑制剂与伦伐替尼联合 PD-1 抑制剂治疗浸润性 HCC 的疗效:共纳入232例患者。114例患者接受了伦伐替尼联合PD-1抑制剂治疗(Len+PD-1组),118例患者接受了HAIC联合伦伐替尼和PD-1抑制剂治疗(HAIC+Len+PD-1组)。通过倾向评分匹配(PSM)比较了两组患者的总生存期(OS)、无进展生存期(PFS)和安全性:结果:Len+PD-1组的6个月、12个月和24个月OS率分别为93.8%、65.1%和13.4%,HAIC+Len+PD-1组分别为100%、77.3%和32.1%。Len+PD-1组的3个月、6个月和12个月的PFS率分别为86.4%、45.7%和14.1%,HAIC+Len+PD-1组分别为95.1%、59.3%和25.9%。在OS(P=0.002)和PFS(P=0.004)方面,HAIC+Len+PD-1组的生存率明显优于Len+PD-1组。亚组分析显示,HAIC+Len+PD-1治疗可改善转移患者的OS。治疗后甲胎蛋白(AFP)有反应的患者比无反应的患者生存率更高。此外,HAIC+Len+PD-1组的不良反应(AEs)也在可控范围内:结论:浸润性 HCC 患者接受 HAIC+Len+PD-1 治疗的 OS 和 PFS 均长于 Len+PD-1 治疗。白话摘要:浸润性肝细胞癌(HCC)是一个奇特的群体,在目前的分期系统中没有得到很好的判定,浸润性肝细胞癌患者的治疗方案具有挑战性,临床证据稀少且不足。在这项多中心研究中,我们创新性地分析了肝动脉灌注化疗(HAIC)联合来伐替尼和PD-1抑制剂(HAIC+Len+PD-1)与来伐替尼和PD-1抑制剂联合治疗(Len+PD-1)相比,对浸润性HCC患者的无进展生存期和总生存期更长。此外,进一步的组内分析显示,在伦+PD-1组中,有转移和无转移患者的OS存在显著差异。然而,在HAIC+Len+PD-1组中,有转移和无转移患者的OS无差异。治疗后甲胎蛋白(AFP)有反应的患者生存率高于无反应的患者。我们的研究证明,HAIC联合伦伐替尼和PD-1抑制剂可显著改善浸润性HCC的临床疗效。关键词:浸润性肝细胞癌;肝动脉灌注化疗;来伐替尼;PD-1抑制剂;甲胎蛋白反应
{"title":"Hepatic Arterial Infusion Chemotherapy Combined Lenvatinib and PD-1 Inhibitor Showed Improved Survival for Infiltrative Hepatocellular Carcinoma: A Multicenter Cohort Study","authors":"Ruixia Li, Xiaohui Wang, Hui Li, Murong Wang, Juncheng Wang, Wei Wang, Qunfang Zhou","doi":"10.2147/jhc.s477872","DOIUrl":"https://doi.org/10.2147/jhc.s477872","url":null,"abstract":"&lt;strong&gt;Purpose:&lt;/strong&gt; Lenvatinib and programmed cell death protein-1 (PD-1) inhibitor on infiltrative hepatocellular carcinoma (HCC) have obtained demonstrated efficacy and still need improvement. Hepatic arterial infusion chemotherapy (HAIC) has shown promising results for advanced HCC. This study aimed to compare the efficacy of HAIC combined Lenvatinib and PD-1 inhibitor versus Lenvatinib combined PD-1 inhibitor for infiltrative HCC.&lt;br/&gt;&lt;strong&gt;Patients and Methods:&lt;/strong&gt; A total of 232 patients were enrolled. There were 114 patients received Lenvatinib combined PD-1 inhibitor (Len+PD-1 group) and 118 patients received HAIC combined Lenvatinib and PD-1 inhibitor (HAIC+Len+PD-1 group). Overall survival (OS), progression-free survival (PFS) and safety of patients were compared between the two groups by propensity score–matching (PSM).&lt;br/&gt;&lt;strong&gt;Results:&lt;/strong&gt; The 6-, 12-, and 24-month OS rates were 93.8%, 65.1% and 13.4% in Len+PD-1 group, and 100%, 77.3% and 32.1% in HAIC+Len+PD-1 group, respectively. The 3-, 6-, and 12-month PFS rates were 86.4%, 45.7% and 14.1% in Len+PD-1 group, and 95.1%, 59.3% and 25.9% in HAIC+Len+PD-1 group, respectively. The HAIC+Len+PD-1 group had obviously better survival than the Len+PD-1 group both in OS (P=0.002) and PFS (P=0.004). Subgroup analysis revealed that OS in patients with metastasis was improved with HAIC+Len+PD-1 treatment. Patients with alpha-fetoprotein (AFP) response after treatment showed better survival than the non-response. In addition, HAIC+Len+PD-1 group showed manageable adverse events (AEs).&lt;br/&gt;&lt;strong&gt;Conclusion:&lt;/strong&gt; Patient with infiltrative HCC, HAIC+Len+PD-1 treatment had longer OS and PFS than Len+PD-1 treatment. Early AFP response was an effective indicator of better survival and tumor response to therapy.&lt;br/&gt;&lt;br/&gt;&lt;strong&gt;Plain Language Summary:&lt;/strong&gt; Infiltrative hepatocellular carcinoma (HCC) is an odd group that is not well adjudicated in the current staging systems, and treatment options for patients with infiltrative HCC are challenging with scant and insufficient clinical evidence. In this multi-center study, we innovatively analyzed the outcome of hepatic arterial infusion chemotherapy (HAIC) combined lenvatinib and PD-1 inhibitor (HAIC+Len+PD-1) was associated longer progression-free survival and overall survival than Lenvatinib plus PD-1 inhibitor combination (Len+PD-1) for patient with infiltrative HCC. In addition, further intragroup analysis revealed that OS of patients with and without metastasis in Len+PD-1 group was significant difference. However, no difference was observed in OS for patients with and without metastasis in HAIC+Len+PD-1 group. Patients with alpha-fetoprotein (AFP) response after treatment showed better survival than the non-response. Our research provides evidence that HAIC combined Lenvatinib and PD-1 inhibitor results in clinically significant improvements in infiltrative HCC. It could be recommended as a first choice for infiltr","PeriodicalId":15906,"journal":{"name":"Journal of Hepatocellular Carcinoma","volume":"33 1","pages":""},"PeriodicalIF":4.1,"publicationDate":"2024-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142183072","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Effect of Low-Dose Aspirin Use After Thermal Ablation in Patients with Hepatocellular Carcinoma: A Retrospective Study 肝细胞癌患者热消融术后服用小剂量阿司匹林的影响:一项回顾性研究
IF 4.1 3区 医学 Q2 ONCOLOGY Pub Date : 2024-09-07 DOI: 10.2147/jhc.s435524
Shanshan Chen, Youjia Duan, Yongchao Zhang, Long Cheng, Liang Cai, Xiaopu Hou, Xiaojun Wang, Wei Li
Purpose: To determine the effect of aspirin on hepatocellular carcinoma (HCC) recurrence and survival after thermal ablation.
Methods: A retrospective analysis was performed to evaluate the efficacy and safety of aspirin in combination with thermal ablation. The clinical data were collected for the enrolled patients. Progression-free survival (PFS), overall survival (OS), and adverse events were analyzed.
Results: A total of 174 patients with HCC were enrolled. The median PFS was 11.1 (95% confidence interval [CI]: 8.1− 14.0) months for patients who took aspirin and 8.6 (95% CI: 5.5− 11.8) months for patients who did not take aspirin. The median OS of patients in the aspirin group was 76.7 (95% CI: 58.1− 95.3) months and that in the non-aspirin group was 53.5 (95% CI: 42.7− 64.3) months. In patients with non-viral HCC, OS was significantly better for the aspirin group (P = 0.03) after ablation. The PFS of patients who underwent ablation alone in the aspirin group was obviously superior to that of patients in the non-aspirin group (P = 0.002). Stratified Cox regression analysis demonstrated that aspirin use after ablation might be a protective factor in specific HCC patient subgroups. The incidence of major adverse events did not significantly differ between the two groups.
Conclusion: Low-dose aspirin use was associated with better OS in patients with non-viral HCC after thermal ablation. In patients who received thermal ablation alone, the administration of low-dose aspirin could improve PFS. Aspirin use might be a protective factor in some patients after ablation.

Keywords: thermal ablation, aspirin, hepatocellular carcinoma, survival analysis, retrospective study
目的:确定阿司匹林对肝细胞癌(HCC)热消融术后复发和生存的影响:方法:对阿司匹林联合热消融的疗效和安全性进行回顾性分析。研究收集了入组患者的临床数据。分析无进展生存期(PFS)、总生存期(OS)和不良事件:结果:共有 174 例 HCC 患者入组。服用阿司匹林患者的中位无进展生存期为 11.1 个月(95% 置信区间 [CI]:8.1- 14.0),未服用阿司匹林患者的中位无进展生存期为 8.6 个月(95% 置信区间 [CI]:5.5- 11.8)。阿司匹林组患者的中位OS为76.7(95% CI:58.1- 95.3)个月,未服用阿司匹林组患者的中位OS为53.5(95% CI:42.7- 64.3)个月。在非病毒性 HCC 患者中,阿司匹林组患者消融后的 OS 明显更好(P = 0.03)。阿司匹林组单纯消融患者的生存期明显优于非阿司匹林组患者(P = 0.002)。分层 Cox 回归分析表明,在特定的 HCC 患者亚群中,消融术后服用阿司匹林可能是一个保护因素。两组患者的主要不良事件发生率无明显差异:结论:在接受热消融术的非病毒性HCC患者中,小剂量阿司匹林与较好的OS相关。在单纯接受热消融的患者中,服用小剂量阿司匹林可改善PFS。使用阿司匹林可能是某些患者消融术后的保护因素。关键词:热消融;阿司匹林;肝细胞癌;生存分析;回顾性研究
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引用次数: 0
Differences in Prediagnostic Serum Metabolomic and Lipidomic Profiles Between Cirrhosis Patients with and without Incident Hepatocellular Carcinoma 有肝细胞癌和没有肝细胞癌的肝硬化患者诊断前血清代谢组学和脂质组学特征的差异
IF 4.1 3区 医学 Q2 ONCOLOGY Pub Date : 2024-09-07 DOI: 10.2147/jhc.s474010
Hannah Powell, Cristian Coarfa, Elisa Ruiz-Echartea, Sandra L Grimm, Omar Najjar, Bing Yu, Luis Olivares, Michael E Scheurer, Christie Ballantyne, Abeer Alsarraj, Emad Mohamed Salem, Aaron P Thrift, Hashem B El Serag, Salma Kaochar
Background: Early detection of hepatocellular carcinoma (HCC) is crucial for improving patient outcomes, but we lack robust clinical biomarkers. This study aimed to identify a metabolite and/or lipid panel for early HCC detection.
Methods: We developed a high-resolution liquid chromatography mass spectrometry (LC-MS)-based profiling platform and evaluated differences in the global metabolome and lipidome between 28 pre-diagnostic serum samples from patients with cirrhosis who subsequently developed HCC (cases) and 30 samples from patients with cirrhosis and no HCC (controls). We linked differentially expressed metabolites and lipids to their associated genes, proteins, and transcriptomic signatures in publicly available datasets. We used machine learning models to identify a minimal panel to distinguish between cases and controls.
Results: Among cases compared with controls, 124 metabolites and 246 lipids were upregulated, while 208 metabolites and 73 lipids were downregulated. The top upregulated metabolites were glycoursodeoxycholic acid, 5-methyltetrahydrofolic acid, octanoyl-coenzyme A, and glycocholic acid. Elevated lipids comprised glycerol lipids, cardiolipin, and phosphatidylethanolamine, whereas suppressed lipids included oxidized phosphatidylcholine and lysophospholipids. There was an overlap between differentially expressed metabolites and lipids and previously published transcriptomic signatures, illustrating an association with liver disease severity. A panel of 12 metabolites that distinguished between cases and controls with an area under the receiver operating curve of 0.98 for the support vector machine (interquartile range, 0.9– 1).
Conclusion: Using prediagnostic serum samples, we identified a promising metabolites panel that accurately identifies patients with cirrhosis who progressed to HCC. Further validation of this panel is required.

背景:早期检测肝细胞癌(HCC)对改善患者预后至关重要,但我们缺乏可靠的临床生物标志物。本研究旨在确定用于早期检测 HCC 的代谢物和/或脂质面板:方法:我们开发了一种基于高分辨率液相色谱质谱(LC-MS)的分析平台,并评估了28份诊断前血清样本(来自随后发展为HCC的肝硬化患者(病例))与30份样本(来自无HCC的肝硬化患者(对照组))之间的全局代谢组和脂质组的差异。我们将差异表达的代谢物和脂质与公开数据集中的相关基因、蛋白质和转录组特征联系起来。我们使用机器学习模型确定了区分病例和对照组的最小面板:结果:与对照组相比,病例中有124种代谢物和246种脂类上调,208种代谢物和73种脂类下调。上调最多的代谢物是糖脱氧胆酸、5-甲基四氢叶酸、辛酰辅酶 A 和甘氨胆酸。升高的脂质包括甘油脂质、心磷脂和磷脂酰乙醇胺,而抑制的脂质包括氧化磷脂酰胆碱和溶血磷脂。差异表达的代谢物和脂质与之前发表的转录组特征有重叠,这说明它们与肝病的严重程度有关。支持向量机的接收器工作曲线下面积为 0.98(四分位间范围为 0.9-1),由此得出结论:12 种代谢物组成的小组能够区分病例和对照组:通过使用诊断前血清样本,我们发现了一个很有前景的代谢物面板,它能准确识别进展为 HCC 的肝硬化患者。我们还需要对这一面板进行进一步验证。
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引用次数: 0
TACE Combined with Portal Vein Tumor Thrombus 125I Seed Implantation in the Treatment of HCC with Hepatic Arterioportal Shunts. TACE联合门静脉瘤栓125I粒子植入术治疗伴肝动脉门静脉分流的HCC
IF 4.2 3区 医学 Q2 ONCOLOGY Pub Date : 2024-09-02 eCollection Date: 2024-01-01 DOI: 10.2147/JHC.S480082
Wei-Li Xia, Xiao-Hui Zhao, Yuan Guo, Hong-Tao Hu, Hai-Liang Li

Background and objectives: Transarterial chemoembolization (TACE) and 125I seed implantation are methods used to treat hepatocellular carcinoma (HCC) with portal vein tumor thrombus (PVTT), PVTT often associated with arterioportal shunts(APS), there are few reports on the combined use of TACE and 125I seed implantation for such patients. This study aimed to evaluate the efficacy and safety of TACE combined with PVTT 125I seed implantation in the treatment of HCC patients with APS.

Methods: Forty-two patients diagnosed with HCC combined with PVTT and APS between January 2020 and December 2021 were included. Appropriate materials were selected to transarterial embolization of the APS, and 125I seeds were implanted into the PVTT. The occlusion effect was observed and recorded after 3 months, the efficacy of intrahepatic lesions and PVTT was evaluated, and the patient survival, prognostic factors affecting APS recanalization were analyzed.

Results: All 42 patients completed the follow-up three months after treatment. The immediate APS improvement rate was 100%, and the APS improvement rate at the three-month follow-up was 64.29%. The disease control rates of PVTT and intrahepatic lesions were 81.00% and 78.60%, respectively. The patients' 6-month and 12-month survival rates were 78.6% and 46.8%. The median OS for all patients was 11.90 months, and the median OS was 13.30 months in the APS effective treatment group and 8.30 months in the ineffective group. The PVTT type is the only independent factor affecting APS recanalization. (P=0.02).

Conclusion: For HCC patients with PVTT and APS, TACE combine with 125I seed implantation in PVTT is a potentially effective and safe method that contributes to prolonging patient survival.

背景和目的:经动脉化疗栓塞术(TACE)和125I粒子植入术是用于治疗伴有门静脉肿瘤血栓(PVTT)的肝细胞癌(HCC)的方法。本研究旨在评估TACE联合PVTT 125I粒子植入治疗伴有APS的HCC患者的有效性和安全性:纳入2020年1月至2021年12月期间确诊的42例合并PVTT和APS的HCC患者。选择合适的材料对 APS 进行经动脉栓塞,并将 125I 粒子植入 PVTT。观察并记录3个月后的闭塞效果,评估肝内病变和PVTT的疗效,分析患者生存率、影响APS再闭塞的预后因素:42例患者均在治疗后3个月完成随访。结果:42 例患者均在治疗后三个月完成随访,APS 即时改善率为 100%,三个月随访时的 APS 改善率为 64.29%。PVTT和肝内病变的疾病控制率分别为81.00%和78.60%。患者的 6 个月和 12 个月生存率分别为 78.6% 和 46.8%。所有患者的中位生存期为 11.90 个月,APS 有效治疗组患者的中位生存期为 13.30 个月,无效治疗组患者的中位生存期为 8.30 个月。PVTT类型是影响APS再通的唯一独立因素(P=0.02)。(P=0.02):对于PVTT和APS的HCC患者,TACE联合125I粒子植入PVTT是一种潜在有效且安全的方法,有助于延长患者的生存期。
{"title":"TACE Combined with Portal Vein Tumor Thrombus <sup>125</sup>I Seed Implantation in the Treatment of HCC with Hepatic Arterioportal Shunts.","authors":"Wei-Li Xia, Xiao-Hui Zhao, Yuan Guo, Hong-Tao Hu, Hai-Liang Li","doi":"10.2147/JHC.S480082","DOIUrl":"10.2147/JHC.S480082","url":null,"abstract":"<p><strong>Background and objectives: </strong>Transarterial chemoembolization (TACE) and <sup>125</sup>I seed implantation are methods used to treat hepatocellular carcinoma (HCC) with portal vein tumor thrombus (PVTT), PVTT often associated with arterioportal shunts(APS), there are few reports on the combined use of TACE and <sup>125</sup>I seed implantation for such patients. This study aimed to evaluate the efficacy and safety of TACE combined with PVTT <sup>125</sup>I seed implantation in the treatment of HCC patients with APS.</p><p><strong>Methods: </strong>Forty-two patients diagnosed with HCC combined with PVTT and APS between January 2020 and December 2021 were included. Appropriate materials were selected to transarterial embolization of the APS, and <sup>125</sup>I seeds were implanted into the PVTT. The occlusion effect was observed and recorded after 3 months, the efficacy of intrahepatic lesions and PVTT was evaluated, and the patient survival, prognostic factors affecting APS recanalization were analyzed.</p><p><strong>Results: </strong>All 42 patients completed the follow-up three months after treatment. The immediate APS improvement rate was 100%, and the APS improvement rate at the three-month follow-up was 64.29%. The disease control rates of PVTT and intrahepatic lesions were 81.00% and 78.60%, respectively. The patients' 6-month and 12-month survival rates were 78.6% and 46.8%. The median OS for all patients was 11.90 months, and the median OS was 13.30 months in the APS effective treatment group and 8.30 months in the ineffective group. The PVTT type is the only independent factor affecting APS recanalization. (<i>P</i>=0.02).</p><p><strong>Conclusion: </strong>For HCC patients with PVTT and APS, TACE combine with <sup>125</sup>I seed implantation in PVTT is a potentially effective and safe method that contributes to prolonging patient survival.</p>","PeriodicalId":15906,"journal":{"name":"Journal of Hepatocellular Carcinoma","volume":"11 ","pages":"1689-1697"},"PeriodicalIF":4.2,"publicationDate":"2024-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11378794/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142154312","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}
引用次数: 0
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Journal of Hepatocellular Carcinoma
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