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首页> 外文期刊>Hepatology: Official Journal of the American Association for the Study of Liver Diseases >A computed tomography radiogenomic biomarker predicts microvascular invasion and clinical outcomes in hepatocellular carcinoma
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A computed tomography radiogenomic biomarker predicts microvascular invasion and clinical outcomes in hepatocellular carcinoma

机译：计算机断层扫描放射基因组生物标志物可预测肝细胞癌的微血管侵袭和临床结局

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Microvascular invasion (MVI) in hepatocellular carcinoma (HCC) is an independent predictor of poor outcomes subsequent to surgical resection or liver transplantation (LT); however, MVI currently cannot be adequately determined preoperatively. Radiogenomic venous invasion (RVI) is a contrast-enhanced computed tomography (CECT) biomarker of MVI derived from a 91-gene HCC venous invasion gene expression signature. Preoperative CECTs of 157 HCC patients who underwent surgical resection (N=72) or LT (N=85) between 2000 and 2009 at three institutions were evaluated for the presence or absence of RVI. RVI was assessed for its ability to predict MVI and outcomes. Interobserver agreement for scoring RVI was substantial among five radiologists (=0.705; P<0.001). The diagnostic accuracy, sensitivity, and specificity of RVI in predicting MVI was 89%, 76%, and 94%, respectively. Positive RVI score was associated with lower overall survival (OS) than negative RVI score in the overall cohort (P<0.001; 48 vs. >147 months), American Joint Committee on Cancer tumor-node-metastasis stage II (P<0.001; 34 vs. >147 months), and in LT patients within Milan criteria (P<0.001; 69 vs. >147 months). Positive RVI score also portended lower recurrence-free survival at 3 years versus negative RVI score (P=0.001; 27% vs. 62%). Conclusion: RVI is a noninvasive radiogenomic biomarker that accurately predicts histological MVI in HCC surgical candidates. Its presence on preoperative CECT is associated with early disease recurrence and poor OS and may be useful for identifying patients less likely to derive a durable benefit from surgical treatment. (Hepatology 2015;62:792-800)
机译：肝细胞癌（HCC）中的微血管浸润（MVI）是手术切除或肝移植（LT）后不良预后的独立预测因子;但是，目前尚无法在术前充分确定MVI。放射基因组静脉侵袭（RVI）是MVI的对比增强计算机断层扫描（CECT）生物标志物，其源自91基因HCC静脉侵袭基因表达特征。在2000年至2009年之间，对三个机构接受手术切除（N = 72）或LT（N = 85）的157例HCC患者的术前CECT进行了RVI评估。评估了RVI预测MVI和结果的能力。在五名放射科医师中，观察员之间达成的对RVI评分的协议是实质性的（= 0.705; P <0.001）。 RVI预测MVI的诊断准确性，敏感性和特异性分别为89％，76％和94％。在整个队列研究中，RVI阳性与总体生存率（OS）低于阴性RVI评分（P <0.001; 48 vs.> 147个月），美国癌症肿瘤结节转移联合委员会第二阶段（P <0.001; 34个月对大于147个月）和米兰标准范围内的LT患者（P <0.001; 69对大于147个月）。 RVI阳性也预示了3年的无复发生存率低于RVI阴性（P = 0.001; 27％比62％）。结论：RVI是一种无创放射基因组生物标志物，可准确预测HCC手术候选者的组织学MVI。它在术前CECT上的存在与疾病的早期复发和OS差有关，可能对确定不太可能从手术治疗中获得持久益处的患者有用。 （肝病2015; 62：792-800）

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