使用成像生物标志物的解码瘤异质性预测了TACE加上免疫治疗和针对性治疗对HCC的反应 (CHANCE2204)
Zhi-Cheng Jin1,2, Jingwei Wei3, Yu-Dong Xiao1,4
1Department of Radiology, Center of Interventional Radiology and Vascular Surgery, Nurturing Center of Jiangsu Province for State Laboratory of AI Imaging & Interventional Radiology, Zhongda Hospital, Medical School, Southeast University, Nanjing, China.
Hepatology (Baltimore, Md.)
|November 10, 2025
概括
结合全球和内异质性的新型成像生物标志物预测了接受跨动脉化血栓化,免疫检查点抑制剂和分子向治疗 (TACE-ICI-MTT) 的肝细胞癌 (HCC) 患者的治疗反应和生存率. 这种生物标志物也反映了瘤.
科学领域:
- 在瘤学瘤学.
- 放射学 放射学是一门学科.
- 免疫学 免疫学 免疫学
背景情况:
- 肝细胞癌 (HCC) 治疗涉及复杂的疗法,如跨动脉化学栓塞结合免疫检查点抑制剂加分子向疗法 (TACE-ICI-MTT).
- 量化内异质性 (ITH) 和确定预后成像生物标志物对于优化HCC患者结果至关重要.
- 在接受TACE-ICI-MTT治疗的HCC患者中预测治疗反应和生存率仍然是一个临床挑战.
研究的目的:
- 量化HCC.中的内异质性 (ITH).
- 为了确定TACE-ICI-MTT治疗的HCC患者的预后成像生物标志物.
- 使用放射性特征开发治疗反应和生存的预测模型.
主要方法:
- 分析了一组742名无法切除的HCC患者的多中心队列,这些患者接受了第一线TACE-ICI-MTT治疗.
- 从预治疗CT扫描中提取了代表全球瘤区域 (GTRs) 和ITH的放射性特征.
- 通过主要组件分析和集体学习来预测反应,生成一个复合的GTR-ITH得分.
主要成果:
- GTR-ITH评分模型实现了高分辨性性能 (AUC:0.94培训,0.82内部验证,0.83独立测试).
- 该GTR-ITH得分强烈预测了治疗反应 (OR:34.39) 和整体存活率 (HR:0.63).
- 低风险的GTR-ITH患者表现出明显延长的无进展和整体存活时间,具有免疫炎症的微环境.
结论:
- 一种新型的成像放射性生物标志物整合了全球和内异质性,可在接受TACE-ICI-MTT的HCC患者中强有力的预测治疗反应和生存率.
- 这个GTR-ITH得分作为HCC的宝贵预后工具.
- 生物标志物反映了潜在的免疫微环境表型,提供了对治疗机制的见解.
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