scholarly journals Post-operative AFP identifies a subset of patients at high risk of early recurrence in hepatitis b-associated hepatocellular carcinoma

HPB ◽  
2017 ◽  
Vol 19 ◽  
pp. S102-S103
Author(s):  
S. Bhagwandin ◽  
Q. Wang ◽  
W. Luan ◽  
L. Warren ◽  
M. Fiel ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
High Risk ◽  
Hepatitis B ◽  
Early Recurrence

Contrast-enhanced ultrasound–based ultrasomics score: a potential biomarker for predicting early recurrence of hepatocellular carcinoma after resection or ablation

2021 ◽  
Author(s):  
Hui Huang ◽  
Si-min Ruan ◽  
Meng-fei Xian ◽  
Ming-de Li ◽  
Mei-qing Cheng ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
High Risk ◽  
Risk Group ◽  
Early Recurrence ◽  
High Risk Group ◽  
Low Risk ◽  
Primary Hepatocellular Carcinoma ◽  
Contrast Enhanced Ultrasound ◽  
Combined Model ◽  
Contrast Enhanced

Objectives: This study aimed to construct a prediction model based on contrast-enhanced ultrasound (CEUS) ultrasomics features and investigate its efficacy in predicting early recurrence (ER) of primary hepatocellular carcinoma (HCC) after resection or ablation. Methods: This study retrospectively included 215 patients with primary HCC, who were divided into a developmental cohort (n = 139) and a test cohort (n = 76). Four representative images—grayscale ultrasound, arterial phase, portal venous phase and delayed phase —were extracted from each CEUS video. Ultrasomics features were extracted from tumoral and peritumoral area inside the region of interest. Logistic-regression was used to establish models, including a tumoral model, a peritumoral model and a combined model with additional clinical risk factors. The performance of the three models in predicting recurrence within 2 years was verified. Results: The combined model performed best in predicting recurrence within 2 years, with an area under the curve (AUC) of 0.845, while the tumoral model had an AUC of 0.810 and the peritumoral model one of 0.808. For prediction of recurrence-free survival, the 2 year cumulative recurrence rate was significant higher in the high-risk group (76.5%) than in the low-risk group (9.5%; p < 0.0001). Conclusion: These CEUS ultrasomics models, especially the combined model, had good efficacy in predicting early recurrence of HCC. The combined model has potential for individual survival assessment for HCC patients undergoing resection or ablation. Advances in knowledge: CEUS ultrasomics had high sensitivity, specificity and PPV in diagnosing early recurrence of HCC, and high efficacy in predicting early recurrence of HCC (AUC > 0.8). The combined model performed better than the tumoral ultrasomics model and peritumoral ultrasomics model in predicting recurrence within 2 years. Recurrence was more likely to occur in the high-risk group than in the low-risk group, with 2-year cumulative recurrence rates respectively 76.5% and 9.5% (p < 0.0001).

scholarly journals Hepatocellular carcinoma: Intratumoral EpCAM-positive cancer stem cell heterogeneity identifies high-risk tumor subtype

2020 ◽  
Author(s):  
Jenny Krause ◽  
Johann von Felden ◽  
Christian Casar ◽  
Thorben W. Fründt ◽  
Johanna Galaski ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
High Risk ◽  
Spatial Heterogeneity ◽  
Early Recurrence ◽  
Epcam Expression ◽  
Clinical Endpoints ◽  
Time To Recurrence ◽  
Dismal Prognosis ◽  
The Impact ◽  
Intratumoral Distribution

Abstract Background: The translational interest in the intratumoral heterogeneity of hepatocellular carcinoma (HCC) has been increasing. The dismal prognosis of this pathology is linked to the features of the HCC harbouring cancer stem cells (CSC), represented by EpCAM-expression. However, the extent of the impact of intratumoral distribution of CSC-features, both on the recurrence after curative resection and on clinical outcome, remains unknown. To address this, we investigated the spatial heterogeneity of CSC-features with the aim of identifying the unique HCC patient subgroups amenable to adjuvant treatment.Methods: We designed a tissue microarray (TMA) from patients who had received liver resection between 2011 and 2017. Tumor specimens were sampled at multiple locations (n=3-8). EpCAM-positivity was assessed for intensity and proportion by applying a score dividing three groups: (i) negative (E-/-); (ii) heterogeneous (E-/+); and (iii) homogeneous (E+/+). The groups were further analysed with regard to time-to-recurrence (TTR) and recurrence-free-survival (RFS).Results: We included 314 tumor spots from 69 patients (76.8% male, median age 66 years, liver cirrhosis/fibrosis 75.8). The risk factors were alcohol abuse (26.2%), NASH (13.1%), HBV (15.5%), HCV (17.9%) and others (27.4%), representative of a typical Western cohort. E+/+ patients experienced significantly shorter TTR and RFS compared to E+/- (and E-/-) patients (TTR 5 vs. 19 months, p=0.022; RFS 5 vs. 14 vs. 21 months, p=0.016). Only homogeneous EpCAM-positivity correlated with higher AFP levels (>400 ng/ml, p=0.031).Conclusions: Spatial heterogeneity of EpCAM-expression was markedly present in the cohort. Of note, only homogeneous EpCAM-expression correlated significantly with early recurrence, whereas heterogeneous EpCAM-expression was associated with clinical endpoints comparable to EpCAM-negativity. We identified a unique HCC subtype associated with a high risk of tumor recurrence.

scholarly journals Patients with polyclonal hepatocellular carcinoma are at a high risk of early recurrence and have a poor recurrence-free survival period

2021 ◽  
Author(s):  
Masaki Kaibori ◽  
Kazuko Sakai ◽  
Hideyuki Matsushima ◽  
Hisashi Kosaka ◽  
Kosuke Matsui ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
High Risk ◽  
Copy Number ◽  
Snp Array ◽  
Early Recurrence ◽  
Copy Number Variations ◽  
Survival Period ◽  
Recurrence Free Survival ◽  
Free Survival ◽  
A Genome

Abstract Background/purpose of the study Tumor heterogeneity based on copy number variations is associated with the evolution of cancer and its clinical grade. Clonal composition (CC) represents the number of clones based on the distribution of B-allele frequency (BAF) obtained from a genome-wide single nucleotide polymorphism (SNP) array. A higher CC number represents a high degree of heterogeneity. We hypothesized and evaluated that the CC number in hepatocellular carcinoma (HCC) tissues might be associated with the clinical outcomes of patients. Methods Somatic mutation, whole transcriptome, and copy number variations of 36 frozen tissue samples of operably resected HCC tissues by targeted deepsequencing, RNAseq and SNP array. Results The samples were classified the heterogeneous tumors as poly-CC (n = 26) and the homogeneous tumors as mono-CC (n = 8). The patients with poly-CC had a higher rate of early recurrence and a significantly shorter recurrence-free survival period than the mono-CC patients (7.0 vs. not reached, p = 0.0084). No differences in pathogenic non-synonymous mutations, such as TP53, were observed between the two groups when targeted deep sequencing was applied. A transcriptome analysis showed that cell cycle-related pathways were enriched in the poly-CC tumors, compared with the mono-CC tumors. poly-CC HCC is highly proliferative and has a high risk of early recurrence. Conclusion CC is a candidate biomarker for predicting the risk of early postoperative recurrence and warrants further investigation.

Surveillance for hepatocellular carcinoma in people of African ancestry with HIV and Hepatitis B

2021 ◽  
pp. 095646242110428
Author(s):  
Nisha Patel ◽  
Frank A Post
Keyword(s):  
Hepatocellular Carcinoma ◽  
High Risk ◽  
Hepatitis B ◽  
African Ancestry ◽  
Evidence Base ◽  
Electronic Patient Records ◽  
Asian Ethnicity ◽  
Hiv Rna ◽  
Asian Populations ◽  
Ultrasound Surveillance

Current guidelines recommend six-monthly ultrasound surveillance for hepatocellular carcinoma (HCC) in high risk, non-cirrhotic people with HIV and hepatitis B co-infection (HBV). African or Asian ethnicity is considered a risk factor for the development of HCC. Risk stratification scores for HCC have been generated in HBV mono-infected Caucasian and Asian populations, however they not been validated in people with HIV or those of African ancestry. We undertook an audit of HCC surveillance in HIV/HBV co-infected individuals of African ancestry who participated in the GEN-AFRICA study. Electronic patient records were reviewed for liver disease characteristics. REACH-B and PAGE-B scores were calculated to ascertain whether individuals at greatest risk of developing HCC were being targeted for ultrasound surveillance. 76 individuals (median age 51 years, 96% HIV RNA < 200 copies/mL, 87% HBV DNA <20 IU/mL) were included. 7% of participants had undergone six-monthly HCC surveillance by liver ultrasound (5% of those at low risk; 9% at intermediate or high risk). Adherence to HCC surveillance was poor and not targeted to those at highest risk. Lack of an evidence base for intensive HCC screening of non-cirrhotic, HIV/HBV co-infected individuals of African ancestry may have contributed to the poor uptake of biannual HCC ultrasound surveillance.

Hepatocellular carcinoma (HCC) and hepatic hydatid disease (HHD)

2018 ◽  
pp. 421-430
Author(s):  
Abdullah Jibawi ◽  
Mohamed Baguneid ◽  
Arnab Bhowmick
Keyword(s):  
Hepatocellular Carcinoma ◽  
Liver Transplantation ◽  
Radiofrequency Ablation ◽  
High Risk ◽  
Hepatitis B ◽  
Hydatid Disease ◽  
Risk Groups ◽  
Hepatic Hydatid Disease ◽  
Surgical Options ◽  
Hepatic Hydatid

Hepatocellular carcinoma (HCC) is strongly associated with cirrhosis. High-risk groups include those with hepatitis due to hepatitis B (HBV) or C (HCV) virus. This chapter provides an algorithm for investigating liver nodules in order to diagnose hepatocellular carcinoma. It explores surgical options including resection, liver transplantation, and minimally invasive options, such as radiofrequency ablation. Palliative options are described and an algorithm for the treatment of HCC is presented. The chapter also discusses hepatic hydatid disease, caused by the metacestode stages of Echinococcus granulosus and E. multilocularis.

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