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Nicotinic acid protects against hepatic ischemia-reperfusion injury via suppressing mitochondrial damage-induced ferroptosis 烟酸通过抑制线粒体损伤引起的铁下垂来保护肝脏缺血再灌注损伤
IF 2.1 Q2 Medicine Pub Date : 2025-12-01 DOI: 10.1016/j.livres.2025.11.001
Qian Zeng , Yina Sun , Mengzhen Lei , Zihan Liu , Xijing Yan , Rong Li , Jun Zheng , Jiandong Zha , Lijun Zhang , Xiaoling Guan , Jia Yao

Background and aims

Hepatic ischemia-reperfusion injury (HIRI) is a major contributor to liver dysfunction and failure, particularly in the context of liver transplantation. Its pathogenesis is primarily driven by ferroptosis, oxidative stress, and mitochondrial dysfunction. Given the interplay among these mechanisms through redox imbalance and disrupted energy metabolism, nicotinic acid (NA)—recognized for its antioxidative and metabolic regulatory properties—emerges as a promising therapeutic candidate. This study aims to investigate the protective effects of NA on HIRI and elucidate its underlying mechanisms.

Methods

An HIRI model in mice and a hypoxia/reoxygenation (H/R) model in primary hepatocytes were established to evaluate the effects of NA treatment on oxidative stress. NA was administered prior to model induction. N-acetylcysteine (NAC) was used as a comparator. Comprehensive assessments of ferroptosis, oxidative stress, mitophagy, and mitochondrial biogenesis markers were conducted using Western blotting, immunohistochemistry, immunofluorescence, and biochemical assays.

Results

NA pretreatment reduced serum alanine aminotransferase, aspartate aminotransferase, and lactate dehydrogenase (LDH) levels, suppressed inflammation by decreasing neutrophil infiltration and macrophage activation, and mitigated oxidative stress by lowering reactive oxygen species (ROS) and malondialdehyde (MDA) levels. It enhanced antioxidant defenses, inhibited ferroptosis, and improved mitochondrial health through increased mitophagy, mitochondrial biogenesis, and mitochondrial permeability transition pore (mPTP) stabilization, leading to enhanced ATP production and mitochondrial function in HIRI.

Conclusions

NA improves mitochondrial function by promoting mitophagy and mitochondrial biogenesis, which reduces ferroptosis and oxidative stress, thereby alleviating HIRI.
背景和目的肝缺血再灌注损伤(HIRI)是肝脏功能障碍和衰竭的主要原因,特别是在肝移植的背景下。其发病机制主要由铁下垂、氧化应激和线粒体功能障碍驱动。考虑到这些机制之间通过氧化还原失衡和能量代谢紊乱的相互作用,烟酸(NA)因其抗氧化和代谢调节特性而被认为是一种有希望的治疗候选者。本研究旨在探讨NA对HIRI的保护作用,并阐明其潜在机制。方法建立小鼠HIRI模型和原代肝细胞缺氧/再氧化(H/R)模型,评价NA处理对氧化应激的影响。模型诱导前给予NA。以n -乙酰半胱氨酸(NAC)作为比较物。采用Western blotting、免疫组织化学、免疫荧光和生化分析对铁下垂、氧化应激、线粒体自噬和线粒体生物发生标志物进行综合评估。结果na预处理可降低血清丙氨酸转氨酶、天冬氨酸转氨酶和乳酸脱氢酶(LDH)水平,通过降低中性粒细胞浸润和巨噬细胞活化抑制炎症反应,通过降低活性氧(ROS)和丙二醛(MDA)水平减轻氧化应激。它通过增加线粒体自噬、线粒体生物发生和线粒体通透性过渡孔(mPTP)稳定来增强抗氧化防御,抑制铁下沉,改善线粒体健康,从而增强HIRI中ATP的产生和线粒体功能。结论sna通过促进线粒体自噬和线粒体生物发生改善线粒体功能,减少铁下垂和氧化应激,从而减轻HIRI。
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引用次数: 0
Therapeutic potential of miRNA-26a-encapsulated nanoparticles against hepatocellular carcinoma in a murine model mirna -26a包封纳米颗粒对小鼠肝细胞癌的治疗潜力
IF 2.1 Q2 Medicine Pub Date : 2025-12-01 DOI: 10.1016/j.livres.2025.10.002
Marwa Hassan , Inés Fernández-Piñeiro , Iker Badiola , Mohamed Elzallat , Alejandro Sánchez , Tarek Aboushousha , Ehab Hafiz , Eman El-Ahwany

Background and aims

Hepatocellular carcinoma (HCC) treatment options are limited due to the lack of effective curative therapies, and conventional chemotherapy has often demonstrated limited effectiveness and may be associated with significant toxicity. Therefore, innovative therapeutics for HCC are urgently needed. Here, we aimed to evaluate the effectiveness of microRNA (miRNA)-26a-encapsulated nanoparticles in HCC treatment.

Methods

Span-Oleylamine-chondroitin sulfate were prepared and eighty male BALB/c mice were divided into four groups: (i) negative control group (saline injection), (ii) HCC group (intraperitoneal injection of diethylnitrosamine (DEN), at 50 mg/kg/week for 18 weeks), (iii) miRNA-26a-treated HCC group (intrahepatical injection of 100 nmol free miRNA-26a once weekly for four weeks), and (iv) miRNA-26a-loaded nanoparticles-treated HCC group (intrahepatic injection of miRNA-26a-loaded nanoparticles once weekly for 4 weeks, starting from Week 14 of DEN induction). Then, all mice were subjected to biochemical, genetic, histopathological, and immunohistochemical examinations.

Results

The HCC group showed elevated serum levels of alpha-fetoprotein (AFP), des-gamma-carboxy prothrombin (DCP), vascular endothelial growth factor (VEGF), and tumor necrosis factor-alpha (TNF-alpha), along with upregulated hepatic expression of P70S6K, transforming growth factor-beta, DNA methyltransferase 3 beta (DNMT3b), and Caspase-3 genes, as well as HepPar 1, Ki67, cyclin D1, and arginase 1 proteins (all P < 0.001). miRNA-26a treatment attenuated these changes; moreover, the miRNA-26a-encapsulated nanoparticles caused a more dramatic decrease of these markers, resulting in almost complete restoration of the normal hepatic architecture.

Conclusions

Administration of miRNA-26a-encapsulated nanoparticles induced nearly total regression of HCC, suppression of cancer cell growth and angiogenesis, and induction of tumor necrosis. This study demonstrates the therapeutic efficacy of restoring the imbalanced expression of miRNA in the liver. Therefore, the clinical translation of this miRNA-based strategy warrants further investigation.
背景和目的:由于缺乏有效的治疗方法,肝细胞癌(HCC)的治疗选择有限,传统化疗通常显示出有限的疗效,并可能伴有明显的毒性。因此,迫切需要创新的HCC治疗方法。在这里,我们旨在评估微rna (miRNA)-26a包封纳米颗粒在HCC治疗中的有效性。方法制备氨水-油胺-硫酸软骨素,将80只雄性BALB/c小鼠分为4组:(i)阴性对照组(生理盐水注射),(ii) HCC组(腹腔注射二乙基亚硝胺(DEN), 50 mg/kg/周,连续18周),(iii) miRNA-26a治疗的HCC组(每周1次肝内注射100 nmol游离miRNA-26a,连续4周),(iv)负载miRNA-26a纳米颗粒治疗的HCC组(每周1次肝内注射负载miRNA-26a纳米颗粒,连续4周,从DEN诱导的第14周开始)。然后,对所有小鼠进行生化、遗传、组织病理学和免疫组织化学检查。结果HCC组血清甲胎蛋白(AFP)、去- γ -羧基凝血酶原(DCP)、血管内皮生长因子(VEGF)、肿瘤坏死因子- α (tnf - α)水平升高,肝脏P70S6K、转化生长因子- β、DNA甲基转移酶3 β (DNMT3b)、Caspase-3基因以及HepPar 1、Ki67、cyclin D1、精氨酸酶1蛋白表达上调(P < 0.001)。miRNA-26a治疗可减弱这些变化;此外,包裹mirna -26a的纳米颗粒引起这些标记物更显著的减少,导致几乎完全恢复正常的肝脏结构。结论mirna -26a包埋纳米颗粒可使肝癌细胞几乎完全消退,抑制肿瘤细胞生长和血管生成,诱导肿瘤坏死。本研究证实了恢复肝脏中不平衡的miRNA表达的治疗效果。因此,这种基于mirna的策略的临床翻译值得进一步研究。
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引用次数: 0
Sex differences in hepatic enzymes and transporters involved in pharmacokinetics 肝酶和转运体在药代动力学中的性别差异
IF 2.1 Q2 Medicine Pub Date : 2025-12-01 DOI: 10.1016/j.livres.2025.10.003
Mehak Behal, Zachary McCalla, Xinwen Wang
Females experience adverse drug reactions at approximately twice the rate of males, contributing to drug-related morbidity and mortality in the United States. This disparity has been strongly associated with sex-based differences in pharmacokinetics. Hepatic drug-metabolizing enzymes and transporters, key regulators of pharmacokinetics, exhibit notable sex-based differences in expression and/or activity. However, findings on the sex-specific impacts of these enzymes and transporters are often scattered, highlighting the need for a comprehensive and up-to-date overview of knowledge in this area. This review compiles and analyzes existing data on sex differences in the expression and activity of clinically relevant hepatic drug-metabolizing enzymes and transporters across species, such as cytochrome P450s, UDP-glucuronosyltransferase, carboxylesterases, P-glycoprotein, breast cancer resistance protein, multidrug resistance-associated protein, organic anion-transporting polypeptides and organic cation transporters. It also summarizes how these differences influence clinical pharmacokinetics, adverse drug reactions, and drug dosing regimens. Furthermore, we explore potential underlying mechanisms, including the influence of sex hormones, sex chromosomes and lifestyle-related factors. Lastly, we discuss clinical implications and future directions in the field, highlighting the urgent need for more human-centered research to clarify the sex-specific impact on drug metabolism and transport in human. Such effort will support the development of sex-informed pharmacotherapy strategies that ultimately reduce adverse drug reactions and improve therapeutic outcomes for patients.
在美国,女性经历药物不良反应的比率大约是男性的两倍,导致了与药物相关的发病率和死亡率。这种差异与基于性别的药代动力学差异密切相关。肝脏药物代谢酶和转运蛋白是药代动力学的关键调节因子,在表达和/或活性上表现出显著的性别差异。然而,关于这些酶和转运体的性别特异性影响的研究结果往往是分散的,这突出了对这一领域知识的全面和最新概述的需要。本文对细胞色素p450、udp -葡萄糖醛基转移酶、羧酸酯酶、p -糖蛋白、乳腺癌耐药蛋白、多药耐药相关蛋白、有机阴离子转运多肽和有机阳离子转运蛋白等临床相关肝脏药物代谢酶和转运蛋白的表达和活性的性别差异进行了梳理和分析。它还总结了这些差异如何影响临床药代动力学、药物不良反应和药物给药方案。此外,我们还探讨了潜在的潜在机制,包括性激素、性染色体和生活方式相关因素的影响。最后,我们讨论了该领域的临床意义和未来发展方向,强调迫切需要更多以人类为中心的研究,以阐明性别对人类药物代谢和转运的影响。这些努力将支持性别知情的药物治疗策略的发展,最终减少药物不良反应,改善患者的治疗效果。
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引用次数: 0
Metabolites involvement in the growth and spread of liver cancer 代谢物参与肝癌的生长和扩散
IF 2.1 Q2 Medicine Pub Date : 2025-12-01 DOI: 10.1016/j.livres.2025.10.005
Anurag Kumar Gautam , Vipin Kumar , Archana Bharti Sonkar , Amita Singh , Deepankar Yadav , Nitin Rajan , Pranesh Kumar , Sanjay Singh , Sudipta Saha , Vijayakumar Mahalingam Rajamanickam
Hepatocellular carcinoma (HCC), commonly known as primary liver cancer, is a leading cause of cancer-related mortality worldwide, primarily attributed to changing lifestyles and dietary habits. HCC arises from liver cirrhosis, hepatic fibrosis, or hepatitis B virus infection, and is caused by disruptions in protein and lipid metabolism. These metabolic alterations, recognized as a hallmark of cancer, are pivotal in the progression of chronic liver disease to HCC. Due to its asymptomatic nature in early stages, HCC is often diagnosed at advanced stages when treatment options are limited. Despite being a potentially curative option, liver transplantation remains hindered by high costs and donor scarcity, further compounded by suboptimal long-term success rates. This review examines the critical metabolites that play a part in developing HCC, focusing on their roles as possible biomarkers for disease progression and therapeutic targets. Additionally, the influence of the gut microbiome on HCC development is discussed, highlighting its interplay with metabolic pathways. Understanding the roles of metabolites and the gut microbiome in HCC progression underscores the importance of their potential use in early detection and the development of targeted therapies, offering new avenues for improving patient outcomes.
肝细胞癌(HCC),通常被称为原发性肝癌,是全球癌症相关死亡的主要原因,主要归因于生活方式和饮食习惯的改变。HCC由肝硬化、肝纤维化或乙型肝炎病毒感染引起,由蛋白质和脂质代谢紊乱引起。这些代谢改变被认为是癌症的标志,是慢性肝病向HCC发展的关键。由于早期无症状,HCC通常在治疗选择有限的晚期才被诊断出来。尽管肝移植是一种潜在的治疗选择,但由于成本高和供体稀缺,长期成功率不佳,肝移植仍然受到阻碍。本综述探讨了在HCC发生过程中发挥作用的关键代谢物,重点关注它们作为疾病进展和治疗靶点的可能生物标志物的作用。此外,还讨论了肠道微生物组对HCC发展的影响,强调了其与代谢途径的相互作用。了解代谢物和肠道微生物组在HCC进展中的作用,强调了它们在早期检测和靶向治疗开发中的潜在应用的重要性,为改善患者预后提供了新的途径。
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引用次数: 0
Spatiotemporal liver dynamics: How far can we take them in vitro? 时空肝脏动力学:我们在体外能走多远?
IF 2.1 Q2 Medicine Pub Date : 2025-12-01 DOI: 10.1016/j.livres.2025.11.002
Hanyang Liu
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引用次数: 0
Resmetirom and beyond: A new era in MASLD therapeutics Resmetirom和超越:MASLD治疗的新时代
IF 2.1 Q2 Medicine Pub Date : 2025-12-01 DOI: 10.1016/j.livres.2025.10.004
Tejona Johnson-Moore, Dasia Simmons, Alvina Okafor, D'Era Washington, Padmamalini Baskaran
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引用次数: 0
Corrigendum to “Metformin alleviates cholestasis-associated nephropathy through regulating oxidative stress and mitochondrial function” [Liver Res. 5 (2021) 171–180] “二甲双胍通过调节氧化应激和线粒体功能减轻胆汁淤积相关肾病”的勘误表[肝脏杂志]. 5 (2021)171-180]
IF 2.1 Q2 Medicine Pub Date : 2025-12-01 DOI: 10.1016/j.livres.2025.12.001
Mohammad Mehdi Ommati , Hamidreza Mohammadi , Khadijeh Mousavi , Negar Azarpira , Omid Farshad , Reyhaneh Dehghani , Asma Najibi , Sedigheh Kamran , Hossein Niknahad , Reza Heidari
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引用次数: 0
Targeting lactic acidosis in the tumor microenvironment: Enhancing TACE efficacy in hepatocellular carcinoma 靶向肿瘤微环境中的乳酸酸中毒:增强TACE治疗肝癌的疗效
IF 2.1 Q2 Medicine Pub Date : 2025-12-01 DOI: 10.1016/j.livres.2025.11.004
Shuyi Hao , Hong Yao , Haojie Yu , Lijun Wang , Tingdong Yu , Hongping Xia , Yong Zha
Lactic acidosis is a hallmark of the tumor microenvironment (TME) and a critical impediment to the efficacy of transarterial chemoembolization (TACE) in hepatocellular carcinoma (HCC). Incomplete embolization preserves viable tumor cells that amplify hypoxia-driven glycolysis, generating a lactic acid-rich milieu that drives treatment resistance, skews immune populations toward immunosuppressive phenotypes, and impairs cytotoxic T lymphocyte function. In this review, we elucidate the pathways through which lactic acidosis compromises TACE efficacy and propose novel strategies for its mitigation. We examine emerging approaches, including systemic or intra-arterial alkalization, targeted inhibition of lactate production and export, and calcium carbonate nanoparticles, and evaluate their respective merits and limitations. Finally, we propose a combination regimen of calcium carbonate nanoparticles, lactate-targeting agents, and TACE to achieve precise drug delivery, synergistic lactic acid depletion, and enhanced antitumor immunity. These integrated strategies have the potential to convert immunologically “cold” HCC lesions into “hot” ones, thereby improving TACE outcomes and disease control.
乳酸性酸中毒是肿瘤微环境(TME)的标志,也是肝细胞癌(HCC)经动脉化疗栓塞(TACE)疗效的关键障碍。不完全栓塞保留了活的肿瘤细胞,这些细胞放大了缺氧驱动的糖酵解,产生了富含乳酸的环境,从而驱动治疗耐药性,使免疫群体偏向免疫抑制表型,并损害细胞毒性T淋巴细胞功能。在这篇综述中,我们阐明了乳酸酸中毒损害TACE疗效的途径,并提出了缓解TACE的新策略。我们研究了新兴的方法,包括全身或动脉内碱化,靶向抑制乳酸的产生和出口,以及碳酸钙纳米颗粒,并评估了它们各自的优点和局限性。最后,我们提出了碳酸钙纳米颗粒、乳酸靶向剂和TACE的联合方案,以实现精确的给药、协同乳酸消耗和增强抗肿瘤免疫。这些综合策略有可能将免疫上的“冷”HCC病变转化为“热”HCC病变,从而改善TACE结果和疾病控制。
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引用次数: 0
Cancer cachexia-related monocytic myeloid-derived suppressor cells impair T-cell negative selection and predict immune-related adverse events 癌症恶病质相关单核细胞髓源性抑制细胞损害t细胞阴性选择并预测免疫相关不良事件
IF 2.1 Q2 Medicine Pub Date : 2025-12-01 DOI: 10.1016/j.livres.2025.10.001
Li Wei , Ya-Qin Sun , Jian-Hua Ren , Ze-Xuan Huang , Yuan Zhang , Xiu-Qing Pang , Xiao-Tong Lv , Xiang-Yuan Wu , Yan-Fang Xing , Xing Li
<div><h3>Background and aims</h3><div>Cancer cachexia is prevalent in various cancers and is associated with chemotherapy toxicity. However, limited data exist on the relationship between cachexia and immune-related adverse events (irAEs). The aim of this study is to explore the correlation between cancer cachexia and irAEs and its possible mechanism.</div></div><div><h3>Methods</h3><div>A murine model of orthotopic hepatocellular carcinoma (HCC) with cachexia was developed to evaluate the impact of T-cell infiltration into multiple tumor-free organs on the occurrence of irAEs. Single-cell RNA sequencing of thymic stromal cells was performed. Additionally, patients with advanced cancers receiving anti-programmed cell death protein 1/ligand 1 (PD-1/L1) antibody treatment were followed to investigate the relationship between cachexia and irAEs.</div></div><div><h3>Results</h3><div>Inflammatory cell infiltration was observed in multiple tumor-free organs of cachexic HCC mice but not in non-cachexic controls. Immunofluorescence confirmed that the infiltrating cells included CD4<sup>+</sup> and CD8<sup>+</sup> T cells. Morphological assessment and hematoxylin–eosin staining revealed thymic atrophy in cachexic HCC mice. Single-cell RNA sequencing of thymic stromal cells showed a reduction in medullary thymic epithelial cells (mTECs) II and III in cachexic mice. Autoimmune regulator (Aire) downregulation was accompanied by decreased expression of tissue-restricted antigens in mTECs. T cells from cachexic HCC mice induced organ-specific inflammation and T-cell infiltration in multiple organs of tumor-free mice. Following anti-mouse PD-1 antibody treatment, the incidence of inflammation in multiple organs markedly increased in cachexic HCC mice and in tumor-free mice that had received T cells from the cachexic HCC mice. Flow cytometry and immunofluorescence analyses revealed enrichment of thymic monocytic myeloid-derived suppressor cells (M-MDSCs) in cachexic HCC mice. M-MDSCs infiltrated the thymus in cachexic mice with cancer, and they induced apoptosis of mTECs from tumor-free mice <em>in vitro</em> via nitric oxide production. Transfer of M-MDSCs led to inflammatory cell infiltration in multiple organs and thymic involution in tumor-free mice without affecting body weight. Sixty-four patients with advanced cancer receiving anti-PD-1/L1 therapy were enrolled. Patients who developed irAEs had higher levels of circulating M-MDSCs than those who did not. Moreover, patients with cachexia (body mass index (BMI) < 20 kg/m<sup>2</sup> or ≥5% weight loss over the past 6 months) had elevated M-MDSC levels. Patients with both high M-MDSC levels and low BMI or weight loss ≥5% experienced more irAEs (hazard ratio: 2.333; 95% confidence interval: 1.231–4.423).</div></div><div><h3>Conclusions</h3><div>M-MDSCs in cachexic mice induced mTEC apoptosis through nitric oxide production, impairing T-cell negative selection and promoting autoimmune T-cell infiltration in
背景和目的癌症恶病质在各种癌症中普遍存在,并与化疗毒性有关。然而,关于恶病质与免疫相关不良事件(irAEs)之间关系的数据有限。本研究旨在探讨癌症恶病质与irAEs的相关性及其可能的机制。方法建立小鼠原位肝癌伴恶病质模型,观察t细胞浸润多脏器对肝癌发生的影响。胸腺基质细胞单细胞RNA测序。此外,对接受抗程序性细胞死亡蛋白1/配体1 (PD-1/L1)抗体治疗的晚期癌症患者进行随访,探讨恶病质与irae的关系。结果恶病质肝癌小鼠多脏器均可见炎性细胞浸润,而非恶病质对照组无炎性细胞浸润。免疫荧光证实浸润细胞包括CD4+和CD8+ T细胞。形态学评价和苏木精-伊红染色显示恶病质肝癌小鼠胸腺萎缩。胸腺基质细胞单细胞RNA测序显示恶病质小鼠胸腺髓质上皮细胞(mTECs) II和III减少。在mtec中,自身免疫调节因子(Aire)下调伴随着组织限制性抗原表达的降低。来自恶病质HCC小鼠的T细胞诱导无瘤小鼠多器官特异性炎症和T细胞浸润。在抗小鼠PD-1抗体治疗后,恶病质HCC小鼠和接受恶病质HCC小鼠T细胞的无瘤小鼠的多器官炎症发生率明显增加。流式细胞术和免疫荧光分析显示,恶病质HCC小鼠胸腺单核细胞髓源性抑制细胞(M-MDSCs)富集。M-MDSCs在恶性肿瘤小鼠胸腺中浸润,并通过一氧化氮的产生诱导无肿瘤小鼠的mTECs凋亡。在不影响体重的情况下,M-MDSCs的转移可导致无肿瘤小鼠多器官的炎症细胞浸润和胸腺退化。64例接受抗pd -1/L1治疗的晚期癌症患者入组。发生irAEs的患者比没有发生irAEs的患者有更高水平的循环M-MDSCs。此外,恶病质患者(体重指数(BMI)≥20 kg/m2或过去6个月体重减轻≥5%)M-MDSC水平升高。高M-MDSC水平和低BMI或体重减轻≥5%的患者经历更多的irae(风险比:2.333;95%可信区间:1.231-4.423)。结论恶病质小鼠sm - mdscs诱导mTEC凋亡的机制包括一氧化氮的产生、t细胞的阴性选择和自身免疫t细胞向无瘤器官的浸润。癌症恶病质相关的M-MDSCs可作为晚期癌症患者irae的预测性生物标志物。
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引用次数: 0
Comparative study of 3D MR elastography and intravoxel incoherent motion for the evaluation of hepatocellular carcinoma grade 三维磁共振弹性成像与体素内非相干运动评价肝癌分级的比较研究
IF 2.1 Q2 Medicine Pub Date : 2025-12-01 DOI: 10.1016/j.livres.2025.11.003
Weimin Liu , Sidong Xie , Wenjie Tang , Ka Zhang

Background and aims

Noninvasive preoperative radiologic prediction of histologic grade—a key prognostic factor—is invaluable. We aim to compare the diagnostic values of 3D magnetic resonance elastography (MRE), intravoxel incoherent motion (IVIM), and conventional contrast-enhanced magnetic resonance imaging (cMRI) in predicting the histologic grade of hepatocellular carcinoma (HCC).

Methods

This institutional review board-approved retrospective study included patients who underwent MRI between December 2014 and October 2021. Sixty-eight patients with pathologically confirmed HCCs who underwent MRE, IVIM, and cMRI imaging were included in the analysis. Two radiologists measured HCC stiffness volumetrically and over a single slice, and also measured apparent diffusion coefficient (ADC), IVIM-derived parameters, and enhancement ratio (ER) on arterial phase images via cMRI. Student’s t-test or the Mann–Whitney U test was used for group comparisons. Receiver operating characteristic (ROC) curve analyses were performed to evaluate the diagnostic performance.

Results

Histologically, fifty-three (78%) patients had well-differentiated or moderately differentiated HCCs, and fifteen (22%) patients had poorly differentiated HCCs. Both the volumetric stiffness and single-ROI tumor stiffness were significantly elevated in the poorly differentiated HCC group (P < 0.001, P = 0.001), and the volumetric stiffness was a better measurement of stiffness because it had a higher ROC curve value (0.816). However, the ADC, the true diffusion coefficient (D), the pseudodiffusion coefficient (D∗), the pseudodiffusion fraction (f), and ER during the arterial phases on cMRI were not significantly different between the two groups (P = 0.309, 0.187, 0.440, 0.350, and 0.714, respectively).

Conclusions

Stiffness measured with 3D MRE may be useful for noninvasively predicting HCC histologic grade, and the volumetric measuring method achieved the highest ROC curve value, outperforming single-ROI HCC stiffness, IVIM parameters, and arterial-phase ER on cMRI.
背景与目的无创术前放射学预测组织学分级是非常重要的预后因素。我们的目的是比较三维磁共振弹性成像(MRE)、体素内非相干运动(IVIM)和常规对比增强磁共振成像(cMRI)在预测肝细胞癌(HCC)组织学分级方面的诊断价值。方法:本研究经机构审查委员会批准,纳入了2014年12月至2021年10月期间接受MRI检查的患者。68例病理证实的hcc患者接受了MRE、IVIM和cMRI成像。两名放射科医生通过体积和单片测量了HCC的硬度,并通过cMRI测量了动脉期图像的表观扩散系数(ADC)、ivim衍生参数和增强比(ER)。组间比较采用学生t检验或Mann-Whitney U检验。采用受试者工作特征(ROC)曲线分析评价诊断效果。结果组织学上,53例(78%)患者为高分化或中分化hcc, 15例(22%)患者为低分化hcc。在低分化HCC组中,体积刚度和单roi肿瘤刚度均显著升高(P < 0.001, P = 0.001),并且体积刚度由于具有更高的ROC曲线值(0.816)而成为更好的刚度测量指标。两组动脉期ADC、真扩散系数(D)、伪扩散系数(D *)、伪扩散分数(f)、ER均无显著差异(P值分别为0.309、0.187、0.440、0.350、0.714)。结论三维磁共振成像测量硬度可用于无创预测HCC组织学分级,体积测量方法获得最高的ROC曲线值,优于单一roi HCC硬度、IVIM参数和cMRI动脉期ER。
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引用次数: 0
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Liver Research
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