Pretreatment radiomic imaging features combined with immunological indicators to predict targeted combination immunotherapy response in advanced hepatocellular carcinoma  

作　　者：Xu Zhang Xu Zhang Qian-Kun Luo Qiang Fu Pan Liu Chang-Jie Pan Chuan-Jiang Liu Hong-Wei Zhang Tao Qin 

机构地区：[1]Department of Hepato-Biliary-Pancreatic Surgery,Zhengzhou University People’s Hospital&Henan Provincial People’s Hospital,Zhengzhou 450003,Henan Province,China

出　　处：《World Journal of Clinical Oncology》2025年第4期154-164,共11页世界临床肿瘤学杂志(英文)

基　　金：Supported by Natural Science Foundation of Henan Province,No.242300421286;the research and practice project of higher education reform in Henan Province,No.2023SJGLX124Y;the research and practice project of higher education reform of Zhengzhou University,No.2023ZZUJGXM114.

摘　　要：BACKGROUND Early symptoms of hepatocellular carcinoma(HCC)are not obvious,and more than 70%of which does not receive radical hepatectomy,when first diagnosed.In recent years,molecular-targeted drugs combined with immunotherapy and other therapeutic methods have provided new treatment options for middle and advanced HCC(aHCC).Predicting the effect of targeted combined immunotherapy has become a hot topic in current research.AIM To explore the relationship between nodule enhancement in hepatobiliary phase and the efficacy of combined targeted immunotherapy for aHCC.METHODS Data from 56 patients with aHCC for magnetic resonance imaging with gadolinium-ethoxybenzyl-diethylenetriamine pentaacetic acid were retrospectively collected.Signal intensity of intrahepatic nodules was measured,and the hepatobiliary relative enhancement ratio(RER)was calculated.Progression-free survival(PFS)of patients with high and low reinforcement of HCC nodules was compared.The model was validated using receiver operating characteristic curves.Univariate and multivariate logistic regression and Kaplan-Meier analysis were performed to explore factors influencing the efficacy of targeted immunization and PFS.RESULTS Univariate and multivariate analyses revealed that the RER,neutrophil-to-lymphocyte ratio,platelet-to-lymphocyte ratio,and prognostic nutritional index were significantly associated with the efficacy of tyrosine kinase inhibitors combined with immunotherapy(P<0.05).The area under the curve of the RER for predicting the efficacy of tyrosine kinase inhibitors combined with anti-programmed death 1 antibody in patients with aHCC was 0.876(95%confidence interval:0.781-0.971,P<0.05),the optimal cutoff value was 0.904,diagnostic sensitivity was 87.5%,and specificity was 79.2%.Kaplan-Meier analysis showed that neutrophil-to-lymphocyte ratio<5,plateletto-lymphocyte ratio<300,prognostic nutritional index<45,and RER<0.9 significantly improved PFS.CONCLUSION AHCC nodules enhancement in the hepatobiliary stage was significantly correlated with

关 键 词：Gadolinium-ethoxybenzyl-diethylenetriamine pentaacetic acid Hepatocellular carcinoma Targeted combination immunotherapy Relative hepatobiliary enhancement ratio Effect prediction 

分 类 号：R73[医药卫生—肿瘤]