Histological tumor micronecrosis in resected specimens after R0 hepatectomy for hepatocellular carcinomas is a factor in determining adjuvant TACE: A retrospective propensity score-matched study.
Histological tumor micronecrosis in resected specimens after R0 hepatectomy for hepatocellular carcinomas is a factor in determining adjuvant TACE: A retrospective propensity score-matched study.
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肝细胞癌 R0 肝切除术后切除标本中的组织学肿瘤微坏死是确定辅助 TACE 的一个因素：一项回顾性倾向评分匹配研究。
DOI：
10.1016/j.ijsu.2022.106852
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发表时间：
2022-08
影响因子：
15.3
通讯作者：
Tingbo Liang
中科院分区：
文献类型：
--
作者：
Yangyang Wang;Hongbin Ge;Manyi Hu;Changrong Pan;Mao Ye;Dipesh Kumar Yadav;Rujia Zheng;Jiajun Wu;Ke Sun;Meng Wang;Yu Tian;Jinyan Huang;Weiyun Yao;Jingsong Li;Qi Zhang;Tingbo Liang
肿瘤微坏死是肝细胞癌（HCC）研究较少的病理特征。本研究旨在评价微坏死在指导辅助性肝动脉化疗栓塞（TACE）治疗HCC中的价值，我们回顾性分析了2014年至2018年在我中心接受根治性肝切除术的HCC患者的数据。将患者分为微坏死（+）和微坏死（-）组。在每组中，比较了接受辅助TACE和未接受辅助TACE的患者的总生存期（OS）和无病生存期（DFS）。倾向评分匹配（PSM）以1：1的比例与对照选择偏倚进行。进行单变量和多变量分析以确定独立的预后因素。采用流式细胞仪检测两组患者的免疫功能状态，共纳入897例患者，其中微坏死（+）组417例，微坏死（-）组480例。PSM后基线参数无显著差异。在微坏死（+）组中，接受辅助TACE的患者的OS显著长于未接受辅助TACE的患者（P = 0.004）。然而，微坏死（-）组的患者并未从辅助TACE中获益。虽然辅助TACE延长了重度微坏死患者的DFS（P = 0.034），但可能对无微坏死患者的DFS产生不利影响（P = 0.131）。多因素分析显示，TACE是微坏死患者的独立预后因素，但对无微坏死患者则无影响。微坏死患者外周血中耗竭性和调节性T细胞的丰度明显升高，对于有微坏死的HCC患者，根治性切除后辅助TACE治疗可改善预后，而对于无微坏死的HCC患者，其生存获益有限。TACE应选择性地应用于微坏死患者，尤其是Nscore = 2的患者。伴有微坏死的肝癌患者的免疫抑制状态可能解释了辅助TACE在此类患者中的有效性。
Tumor micronecrosis is a less investigated pathological feature of hepatocellular carcinoma (HCC). This study was aimed at evaluating the value of micronecrosis for guiding adjuvant transcatheter arterial chemoembolization (TACE) in HCC management.We retrospectively reviewed the data of patients with HCC who underwent curative liver resection in our center from 2014 to 2018. The patients were divided into micronecrosis (+) and micronecrosis (-) groups. In each group, overall survival (OS) and disease-free survival (DFS) were compared between patients who underwent adjuvant TACE and those who did not. Propensity score matching (PSM) was conducted at a ratio of 1:1 to control selection bias. Univariate and multivariate analyses were performed to determine independent prognostic factors. Mass cytometry was applied to compare the immunological status of HCCs between the two groups.A total of 897 patients were included, with 417 and 480 patients in the micronecrosis (+) and micronecrosis (-) groups, respectively. No significant difference was detected in baseline parameters after PSM. In the micronecrosis (+) group, patients who underwent adjuvant TACE had significant longer OS than did those who did not (P = 0.004). However, patients in the micronecrosis (-) group did not benefit from adjuvant TACE. Although adjuvant TACE prolonged the DFS of patients with severe micronecrosis (P = 0.034), it may adversely affect the DFS of patients without micronecrosis (P = 0.131). Multivariate analysis showed that TACE was an independent prognostic factor for patients with micronecrosis but not for those without micronecrosis. The abundance of exhausted and regulatory T cells was significantly higher in patients with micronecrosis.For HCC patients with micronecrosis, adjuvant TACE after curative resection could improve the prognosis, while its survival benefits were limited in HCC patients without micronecrosis. TACE should be selectively performed in patients with micronecrosis, especially those with an Nscore = 2. The immunosuppressive status of HCC patients with micronecrosis may explain the effectiveness of adjuvant TACE in such scinario.
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影响因子：
4.3
作者：
Z. Ren;Zhi-ying Lin;J. Xia;S. Ye;Zeng-chen Ma;Q. Ye;L. Qin;Zhi-quan Wu;Jia Fan;Zhao-You Ta
通讯作者：
Z. Ren;Zhi-ying Lin;J. Xia;S. Ye;Zeng-chen Ma;Q. Ye;L. Qin;Zhi-quan Wu;Jia Fan;Zhao-You Ta
影响因子：
1.5
作者：
Gilles, HoChong;Garbutt, Tonora;Landrum, Jasmine
通讯作者：
Landrum, Jasmine
DOI：
--
发表时间：
2019
期刊：
The Egyptian journal of immunology
影响因子：
--
作者：
Ehsan A. Hassan;Entsar H Ahmed;A. Nafee;Nourhan El-Gafary;H. Hetta;M. El-Mokhtar
通讯作者：
Ehsan A. Hassan;Entsar H Ahmed;A. Nafee;Nourhan El-Gafary;H. Hetta;M. El-Mokhtar
影响因子：
9
作者：
Pinna, Antonio Daniele;Yang, Tian;Cucchetti, Alessandro
通讯作者：
Cucchetti, Alessandro
影响因子：
29.4
作者：
Lee, Joon Hyeok;Lee, Jeong-Hoon;Yoon, Jung-Hwan
通讯作者：
Yoon, Jung-Hwan