PDF(Pubmed)
Abstract：
BACKGROUND: Serum AFP-L3%, AFP, and DCP are useful biomarkers for HCC detection, but their utility in assessing treatment response remains unknown. We aim to evaluate the accuracy of a biomarker model in the detection of posttreatment viable tumors.
METHODS: For model derivation, recipients with HCC undergoing liver transplant from 2018 to 2022 who had biomarkers collected within 3 months before transplant were included. We developed a generalized linear model for detecting posttreatment viable tumors with the 3 biomarkers as covariates, which we termed the \"LAD Score.\" An independent cohort of 117 patients with HCC was used for external validation.
RESULTS: Among 205 recipients of transplant, 70.2% had evidence of viable tumor on explant. The median LAD score was higher among patients with viable versus nonviable tumors (1.06 vs. 0.465, p < 0.001). The LAD score had a sensitivity of 55.6% and a specificity of 85.1% at the cutoff of 0.927, which was more accurate than imaging for detecting posttreatment viable tumors (AUROC 0.736 vs. 0.643, respectively; p = 0.045). The superior performance of the LAD score over imaging is primarily driven by its greater accuracy in detecting tumors <2 cm in diameter (AUROC of the LAD score 0.721 vs. imaging 0.595, p = 0.02). In the validation data set, the LAD score had an AUROC of 0.832 (95% CI: 0.753, 0.911) with a sensitivity of 72.5% and a specificity of 89.4% at the cutoff of 0.927.
CONCLUSIONS: Our findings suggest the utility of LAD score in treatment response assessment after locoregional therapy for HCC, particularly in detecting small tumors. A larger prospective study is in progress to validate its accuracy and evaluate its performance in recurrence monitoring.
METHODS: For model derivation, recipients with HCC undergoing liver transplant from 2018 to 2022 who had biomarkers collected within 3 months before transplant were included. We developed a generalized linear model for detecting posttreatment viable tumors with the 3 biomarkers as covariates, which we termed the \"LAD Score.\" An independent cohort of 117 patients with HCC was used for external validation.
RESULTS: Among 205 recipients of transplant, 70.2% had evidence of viable tumor on explant. The median LAD score was higher among patients with viable versus nonviable tumors (1.06 vs. 0.465, p < 0.001). The LAD score had a sensitivity of 55.6% and a specificity of 85.1% at the cutoff of 0.927, which was more accurate than imaging for detecting posttreatment viable tumors (AUROC 0.736 vs. 0.643, respectively; p = 0.045). The superior performance of the LAD score over imaging is primarily driven by its greater accuracy in detecting tumors <2 cm in diameter (AUROC of the LAD score 0.721 vs. imaging 0.595, p = 0.02). In the validation data set, the LAD score had an AUROC of 0.832 (95% CI: 0.753, 0.911) with a sensitivity of 72.5% and a specificity of 89.4% at the cutoff of 0.927.
CONCLUSIONS: Our findings suggest the utility of LAD score in treatment response assessment after locoregional therapy for HCC, particularly in detecting small tumors. A larger prospective study is in progress to validate its accuracy and evaluate its performance in recurrence monitoring.
摘要：
背景：血清AFP-L3％，法新社,和DCP是肝癌检测的有用生物标志物，但是它们在评估治疗反应方面的效用仍然未知。我们旨在评估生物标志物模型在检测治疗后可行肿瘤中的准确性。
方法：对于模型推导，纳入了2018年至2022年接受肝移植的HCC患者,他们在移植前3个月内收集了生物标志物.我们开发了一个广义线性模型，用于检测治疗后可行的肿瘤，以3个生物标志物为协变量，我们称之为“LAD得分”。“117例HCC患者的独立队列用于外部验证。
结果：在205个移植接受者中，70.2％的外植体上有存活肿瘤的证据。在有存活与无存活肿瘤的患者中，中位LAD评分较高(1.06vs.0.465，p<0.001)。在0.927的临界值时，LAD评分的灵敏度为55.6％，特异性为85.1％，这比成像检测治疗后可行的肿瘤更准确（AUROC0.736vs.分别为0.643；p=0.045）。LAD评分优于成像，主要是由于其在检测直径<2cm的肿瘤方面具有更高的准确性（LAD评分的AUROC0.721vs.成像0.595，p=0.02）。在验证数据集中，LAD评分的AUROC为0.832(95%CI:0.753,0.911),临界值为0.927时的敏感性为72.5%,特异性为89.4%.
结论：我们的发现表明LAD评分在局部区域治疗HCC后的治疗反应评估中的效用，特别是检测小肿瘤。一项更大的前瞻性研究正在进行中，以验证其准确性并评估其在复发监测中的性能。
方法：对于模型推导，纳入了2018年至2022年接受肝移植的HCC患者,他们在移植前3个月内收集了生物标志物.我们开发了一个广义线性模型，用于检测治疗后可行的肿瘤，以3个生物标志物为协变量，我们称之为“LAD得分”。“117例HCC患者的独立队列用于外部验证。
结果：在205个移植接受者中，70.2％的外植体上有存活肿瘤的证据。在有存活与无存活肿瘤的患者中，中位LAD评分较高(1.06vs.0.465，p<0.001)。在0.927的临界值时，LAD评分的灵敏度为55.6％，特异性为85.1％，这比成像检测治疗后可行的肿瘤更准确（AUROC0.736vs.分别为0.643；p=0.045）。LAD评分优于成像，主要是由于其在检测直径<2cm的肿瘤方面具有更高的准确性（LAD评分的AUROC0.721vs.成像0.595，p=0.02）。在验证数据集中，LAD评分的AUROC为0.832(95%CI:0.753,0.911),临界值为0.927时的敏感性为72.5%,特异性为89.4%.
结论：我们的发现表明LAD评分在局部区域治疗HCC后的治疗反应评估中的效用，特别是检测小肿瘤。一项更大的前瞻性研究正在进行中，以验证其准确性并评估其在复发监测中的性能。
