Functional Liver Imaging Score Derived from Gadoxetic Acid-enhanced MRI Predicts Cachexia and Prognosis in Hepatocellular Carcinoma Patients  

作　　者：Xin-xiang LI Bing LIU Yu-fei ZHAO Yang JIANG Ying CUI Xin-gui PENG 

机构地区：[1]Nurturing Center of Jiangsu Province for State Laboratory of AI Imaging&Interventional Radiology,Department of Radiology,Zhongda Hospital,School of Medicine,Southeast University,Nanjing,210009,China [2]Department of Radiology,The First Affiliated Hospital of USTC,Division of Life Sciences and Medicine,University of Science and Technology of China,Hefei,230001,China

出　　处：《Current Medical Science》2024年第5期1018-1025,共8页当代医学科学（英文）

基　　金：supported by grants from National Natural Science Foundation of China(No.82272064);Jiangsu Provincial Science and Technique Program(No.BK20221461);Zhongda Hospital Affiliated to Southeast University,Jiangsu Province High-level Hospital Paring Assistance Construction(No.zdlyg08).

摘　　要：Objective Cachexia occurs in approximately half of hepatocellular carcinoma(HCC)patients as the disease progresses and is correlated with a poor prognosis.Therefore,early identification of HCC patients at risk of developing cachexia and their prognosis is crucial.This study investigated the functional liver imaging score(FLIS)derived from gadoxetic acid-enhanced magnetic resonance imaging(MRI)to identify cachexia in HCC patients and their prognosis.Methods Pretreatment clinical and MRI data from 339 HCC patients who underwent gadoxetic acid-enhanced MRI scans were retrospectively collected.Patient weights were recorded for 6 months following the MRI scan to diagnose cachexia.The FLIS was calculated as the sum of the enhancement quality score,the excretion quality score,and the portal vein sign quality score.A Cox proportional hazards model was used to determine the significant factors affecting overall survival(OS).Multivariable logistic regression was then conducted to identify variables predicting cachexia in HCC patients,which were subsequently used to predict OS.Results Cox regression analysis revealed a significant association between cachexia and worse OS.Both FLIS(0–4 vs.5–6 points)(OR,9.20;95%CI:4.68–18.10;P<0.001)andα-fetoprotein>100 ng/mL(OR,4.08;95%CI:2.13–7.83;P<0.001)emerged as significant predictors of cachexia in patients with HCC.Furthermore,FLIS(0–4 vs.5–6 points)(HR,1.73;95%CI:1.19–2.51;P=0.004)was significantly associated with OS.Patients in the FLIS 0–4 points group had shorter OS than those in the FLIS 5–6 points group[20 months(95%CI,14.7–25.3)vs.43 months(95%CI,27.7–58.3);P=0.001].Conclusion Cachexia was associated with worse OS.The functional liver imaging score emerged as a significant predictor of cachexia in HCC patients and their prognosis.

关 键 词：CACHEXIA hepatocellular carcinoma functional liver imaging score magnetic resonance imaging 

分 类 号：R735.7[医药卫生—肿瘤]