血液肝细胞癌签名识别了具有转移性特征的非常小的瘤结节
Kun Chen1, Junxiao Wang2,3, Liping Jiang4
1State Key Lab of Molecular Oncology, Department of Immunology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Journal of clinical and translational hepatology
|July 8, 2024
概括
一项新的血液测试可以识别放射性废除 (RFA) 之前转移性特征的肝细胞癌 (HCC). 这种签名预测了早期复发,有助于HCC患者的治疗决策.
科学领域:
- 在瘤学瘤学.
- 分子诊断学 分子诊断
- 肝胆道手术 肝胆道手术
背景情况:
- 肝细胞癌 (HCC) 复发后射频除 (RFA) 是一个重要的临床挑战.
- 目前针对小HCC结节的治疗策略通常涉及RFA,但高复发率需要改善治疗前风险分层.
研究的目的:
- 开发和验证一种基于血液的生物标志物签名,用于在RFA之前识别具有转移潜力的HCC.
- 建立一个预测工具,用于在RFA治疗后HCC的早期复发.
主要方法:
- 对HCC患者数据 (2010-2017年) 的回顾性分析,包括RFA前的血样本.
- 血液特征的发展,包括α-fetoprotein,des-γ-carboxy-prothrombin,无细胞DNA (cfDNA) 突变 (TP53,CTNNB1,TERT促进体) 和甲基化.
- 在单独的队列中对HCC血液特征的前性验证 (2021年).
主要成果:
- 开发的HCC血液特征显示出1年复发的高预测准确性 (92%的特异性,91%的回顾性敏感性;87%的特异性,76%的前性敏感性).
- 该签名识别了具有des-γ-carboxy-prothrombin≥40mAU/mL和特定cfDNA突变的患者.
- 在前性病例中,特征阳性与更高的HCC组织得分以及HCC细胞更接近微血管的关系.
结论:
- 可访问的RFA前血液签名可以识别具有转移性特征的HCC.
- 这种血液签名显示出预测RFA后早期HCC复发的前景,可能指导治疗决策.
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