Pathologic assessment of hepatocellular carcinoma in the era of immunotherapy:a narrative review  

作　　者：Han Wang You-Wen Qian Hui Dong Wen-Ming Cong 

机构地区：[1]Department of Pathology,Shanghai Eastern Hepatobiliary Surgery Hospital,Naval Medical University,Shanghai,China

出　　处：《Hepatobiliary Surgery and Nutrition》2024年第3期472-493,共22页肝胆外科与营养（英文）

基　　金：Mengchao Youth Talent Development Program,Shanghai Science and Technology Innovation Action Plan-Medical Innovation Research Project(No.22Y11908700,No.22Y11909100).

摘　　要：Background and Objective:Immune checkpoint inhibitor(ICI)-based therapy has achieved impressive success in various cancer types.Several ICIs have been unprecedentedly approved as the treatment regimens for advanced hepatocellular carcinoma(HCC)in recent decade.Meanwhile,numerous clinical trials are being performed to exploit more ICIs into initially unresectable HCC and postoperative HCC to expectantly induce adequate tumor downstaging for further resection or implement adjuvant treatment for relapse-free survival,respectively.In this review,we aim to summarize some pragmatic histomorphologic,immunohistochemical,and molecular pathologic parameters which promisingly indicate the response of neoadjuvant/conversion ICI-related therapy and predict the efficacy of adjuvant/therapeutic ICI-related therapy for HCC.Methods:We searched PubMed using the terms hepatocellular carcinoma,immunotherapy,immune checkpoint inhibitor,immune checkpoint blockade,conversion therapy,neoadjuvant therapy,adjuvant therapy,biomarker,pathologic evaluation,pathologic assessment till February 2023.Key Content and Findings:Although there is no consensus regarding the pathologic evaluation of relevant HCC specimens,it is encouraging that a few of studies have concentrated on this field,and moreover,the methods and parameters noted on other cancer types are also worthy of reference.For the pathologic assessment of HCC specimens underwent immunotherapy,a suitable sampling scheme,identifying immunotherapy-related pathologic response,and quantification of pathologic response rate should be emphasized.For the patients of HCC who are scheduled to receive immunotherapy,tumor-infiltrating lymphocyte,intratumoral tertiary lymphoid structure,programmed cell death ligand 1,Wnt/β-catenin,microsatellite instability and mismatch repair,tumor mutational burden and tumor neoantigen,as well as some other signaling pathways are the potential predictive biomarkers of treatment response of ICI.Conclusions:The management of HCC in the era of immunotherapy arises a

关 键 词：Hepatocellular carcinoma(HCC) immune checkpoint blockade pathologic evaluation neoadjuvant therapy conversion therapy adjuvant therapy 

分 类 号：R735.7[医药卫生—肿瘤]