研究概要
我们验证了在校正临床病理变量后,LCRS 是独立预后因素(所有 P < 0.05),LCRS-High 组在 HCC、ICC 和 CRLM 中均与更差的生存结局相关。
中文摘要
作为癌症的标志,遗传和表型异质性导致生物标志物通常针对特定癌症类型或亚型量身定制。这种特异性为促进跨多种癌症类型的 streamlined 评估和优化治疗结果带来了复杂性。在本研究中,我们通过无监督聚类分析整合了肝细胞癌(HCC)、肝内胆管癌(ICC)和结直肠癌肝转移(CRLM)的计算机断层扫描(CT)图像的放射组学特征,全面表征了肝癌(LC)的放射学模式。我们识别出三个不同的放射组学聚类,在预后方面表现出异质性。随后,我们通过使用 GGI 策略发现并展示放射组学表型之间的连通性,制定了一个共享的预后指标,即肝癌放射组学特征(LCRS)。我们验证了 LCRS 在调整临床病理变量后是独立预后因素(所有 P < 0.05),LCRS-High 组在 HCC、ICC 和 CRLM 中始终与较差的生存结果相关。然而,LCRS-High 组显示出从辅助化疗中获益,导致疾病复发风险降低和生存改善。相比之下,LCRS-Low 组,包括胃癌肝转移(GCLM)的一个亚组,对基于免疫检查点抑制剂(ICIs)的联合治疗表现出更有利的反应(P = 0.02,风险比(HR):0.34 [95% 置信区间(CI):0.13-0.88])。进一步分析显示,Notch 信号通路在 LCRS-High 肿瘤中富集,而 LCRS-Low 肿瘤表现出更高的NK 细胞浸润。这些发现突出了这种通用评分模型为 LC 患者个性化管理策略的前景。
展开英文摘要原文
As the hallmark of cancer, genetic and phenotypic heterogeneity leads to biomarkers that are typically tailored to specific cancer type or subtype. This specificity introduces complexities in facilitating streamlined evaluations across diverse cancer types and optimizing therapeutic outcomes. In this study, we comprehensively characterized the radiological patterns underlying liver cancer (LC) by integrating radiomics profiles from computed tomography (CT) images of hepatocellular carcinoma (HCC), intrahepatic cholangiocarcinoma (ICC), and colorectal cancer liver metastases (CRLM) through unsupervised clustering analysis. We identified three distinct radiomics clusters, displaying heterogeneity in prognosis. Subsequently, we formulated a shared prognosticator, the liver cancer radiomics signature (LCRS), by discovering and manifesting connectivity among radiomics phenotypes using GGI strategy. We validated that the LCRS is independent prognostic factor after adjusting for clinic-pathologic variables (all P < 0.05), with the LCRS-High group consistently associated with worse survival outcomes across HCC, ICC, and CRLM. However, the LCRS-High group showed clinical benefit from adjuvant chemotherapy, leading to reduced disease recurrence risk and improved survival. By contrast, the LCRS-Low group, including a subset of gastric cancer liver metastases (GCLM), exhibited more favorable response to immune checkpoint inhibitors (ICIs)-based combinational therapy (P = 0.02, hazard ratio (HR): 0.34 [95 % confidence interval (CI): 0.13-0.88]). Further analysis revealed that Notch signaling pathway was enriched in LCRS-High tumors, while LCRS-Low tumors exhibited higher infiltration of natural killer cell. These findings highlight the promise of this universal scoring model to personalize management strategies for patients with LC.
论文信息
- 作者
- Xin H、Lai Q、Liu Y、Liao N、Wang Y、Liao B、Zhou K、Zhou Y
- 第一作者单位
- Department of Gastroenterology, Nanfang Hospital, Southern Medical University, Guangzhou, China.China
- 通讯作者单位
- Department of Gastroenterology, Nanfang Hospital, Southern Medical University, Guangzhou, China. Electronic address: ypzhou@smu.edu.cn.China
- 期刊
- Pharmacological research2024 Dec