PDF(Pubmed)
Abstract：
BACKGROUND: The Liver Imaging Reporting and Data System (LI-RADS) combines standardized terminology with a classification system for imaging findings in patients with HCC, therefore rendering diagnostic biopsy unnecessary in many cases. This retrospective study included 23 patients with a biopsy diagnosis of HCC, performed either before or after local interventional procedures, in order to evaluate the histopathologic changes induced by previous procedures and their potential influence on the response to immune therapy.
METHODS: The study encompassed a cohort of patients diagnosed with Hepatocellular Carcinoma (HCC). Diagnosis was established via contrast-enhanced computer tomography or magnetic resonance imaging that identified LI-RADS-5 nodules in conjunction with historical liver disease and elevated alpha-fetoprotein (AFP) levels or via histological examination confirming positivity for glypican3, heat shock protein 70, and glutamine synthetase. The study detailed the liver disease etiology, LI-RADS scores, characteristics and dimensions of HCC nodules, serum AFP concentrations, Edmondson-Steiner grading, and the expression of programmed cell death ligand 1 (PD-L1) in the tumor cells.
RESULTS: Among the study\'s cohort of Hepatocellular Carcinoma (HCC) patients, a portion had not received any prior treatments, while the remainder experienced local HCC recurrence following trans-arterial chemoembolization or radiofrequency ablation. Observations indicated elevated alpha-fetoprotein (AFP) levels in those who had not undergone any previous interventions, showing statistical significance. The Edmondson-Steiner classification predominantly identified grade III differentiation across patients, irrespective of their treatment history. Furthermore, an increase in intra-tumoral programmed cell death ligand 1 (PD-L1) expression was noted in patients who had not been subjected to previous therapies.
CONCLUSIONS: Liver biopsy offers valuable insights for patients with Hepatocellular Carcinoma (HCC), assisting in the tailoring of immune therapy strategies, particularly in cases of recurrence following prior local interventions.
METHODS: The study encompassed a cohort of patients diagnosed with Hepatocellular Carcinoma (HCC). Diagnosis was established via contrast-enhanced computer tomography or magnetic resonance imaging that identified LI-RADS-5 nodules in conjunction with historical liver disease and elevated alpha-fetoprotein (AFP) levels or via histological examination confirming positivity for glypican3, heat shock protein 70, and glutamine synthetase. The study detailed the liver disease etiology, LI-RADS scores, characteristics and dimensions of HCC nodules, serum AFP concentrations, Edmondson-Steiner grading, and the expression of programmed cell death ligand 1 (PD-L1) in the tumor cells.
RESULTS: Among the study\'s cohort of Hepatocellular Carcinoma (HCC) patients, a portion had not received any prior treatments, while the remainder experienced local HCC recurrence following trans-arterial chemoembolization or radiofrequency ablation. Observations indicated elevated alpha-fetoprotein (AFP) levels in those who had not undergone any previous interventions, showing statistical significance. The Edmondson-Steiner classification predominantly identified grade III differentiation across patients, irrespective of their treatment history. Furthermore, an increase in intra-tumoral programmed cell death ligand 1 (PD-L1) expression was noted in patients who had not been subjected to previous therapies.
CONCLUSIONS: Liver biopsy offers valuable insights for patients with Hepatocellular Carcinoma (HCC), assisting in the tailoring of immune therapy strategies, particularly in cases of recurrence following prior local interventions.
摘要：
背景：肝脏成像报告和数据系统（LI-RADS）将标准化术语与HCC患者影像学发现的分类系统相结合，因此，在许多情况下，不需要进行诊断活检。这项回顾性研究包括23例活检诊断为HCC的患者，在局部介入手术之前或之后进行，为了评估以前手术引起的组织病理学变化及其对免疫治疗反应的潜在影响。
方法：该研究包括一组诊断为肝细胞癌（HCC）的患者。诊断是通过对比增强计算机断层扫描或磁共振成像确定的LI-RADS-5结节与历史肝病和甲胎蛋白（AFP）水平升高或通过组织学检查确认的阳性为Glypican3，热休克蛋白70和谷氨酰胺合成酶。该研究详细介绍了肝病的病因，LI-RADS得分,肝癌结节的特征和尺寸，血清AFP浓度，Edmondson-Steiner评分,以及程序性细胞死亡配体1(PD-L1)在肿瘤细胞中的表达。
结果：在研究的肝细胞癌（HCC）患者队列中，一部分之前没有接受过任何治疗，而其余患者在经肝动脉化疗栓塞或射频消融后出现局部HCC复发。观察结果表明，在那些没有经历过任何干预措施的人中，甲胎蛋白（AFP）水平升高。显示统计学意义。Edmondson-Steiner分类主要确定患者的III级分化，不管他们的治疗历史。此外，在以前未接受过治疗的患者中,肿瘤内程序性细胞死亡配体1(PD-L1)表达增加.
结论：肝活检为肝细胞癌（HCC）患者提供了有价值的见解，协助定制免疫治疗策略，特别是在先前的局部干预后复发的病例。
方法：该研究包括一组诊断为肝细胞癌（HCC）的患者。诊断是通过对比增强计算机断层扫描或磁共振成像确定的LI-RADS-5结节与历史肝病和甲胎蛋白（AFP）水平升高或通过组织学检查确认的阳性为Glypican3，热休克蛋白70和谷氨酰胺合成酶。该研究详细介绍了肝病的病因，LI-RADS得分,肝癌结节的特征和尺寸，血清AFP浓度，Edmondson-Steiner评分,以及程序性细胞死亡配体1(PD-L1)在肿瘤细胞中的表达。
结果：在研究的肝细胞癌（HCC）患者队列中，一部分之前没有接受过任何治疗，而其余患者在经肝动脉化疗栓塞或射频消融后出现局部HCC复发。观察结果表明，在那些没有经历过任何干预措施的人中，甲胎蛋白（AFP）水平升高。显示统计学意义。Edmondson-Steiner分类主要确定患者的III级分化，不管他们的治疗历史。此外，在以前未接受过治疗的患者中,肿瘤内程序性细胞死亡配体1(PD-L1)表达增加.
结论：肝活检为肝细胞癌（HCC）患者提供了有价值的见解，协助定制免疫治疗策略，特别是在先前的局部干预后复发的病例。
