Development and validation of a biomarker index for HCC treatment response.

Humans Liver Neoplasms / blood Carcinoma, Hepatocellular / blood Female Male Middle Aged Biomarkers, Tumor / blood Liver Transplantation alpha-Fetoproteins / analysis Aged Treatment Outcome Sensitivity and Specificity Retrospective Studies

Journal

Hepatology communications
ISSN: 2471-254X
Titre abrégé: Hepatol Commun
Pays: United States
ID NLM: 101695860

Informations de publication

Date de publication:
01 Jul 2024
Historique:
received: 13 12 2023
accepted: 29 02 2024
medline: 19 6 2024
pubmed: 19 6 2024
entrez: 19 6 2024
Statut: epublish

Résumé

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. 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. 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. 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.

Sections du résumé

BACKGROUND 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 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 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 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.

Identifiants

DOI: 10.1097/HC9.0000000000000466 PMID: 38896084
pubmed: 38896084
doi: 10.1097/HC9.0000000000000466
pii: 02009842-202407010-00007
pii:
doi:

Substances chimiques

Biomarkers, Tumor 0
alpha-Fetoproteins 0

Types de publication

Journal Article Validation Study

Langues

eng

Sous-ensembles de citation

IM

Informations de copyright

Copyright © 2024 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the American Association for the Study of Liver Diseases.

Références

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Auteurs

Jeff Liang (J)

Department of Internal Medicine, Cedars-Sinai Medical Center, Los Angeles, California, USA.

Po-Yi Li (PY)

Department of Medicine, Division of Gastroenterology, University of California, San Francisco, San Francisco, California, USA.

Joshua Norman (J)

Department of Internal Medicine, Stanford University, Palo Alto, California, USA.

Marie Lauzon (M)

Biostatistics and Bioinformatics Research Center, Cedars-Sinai Medical Center, Los Angeles, California, USA.

Yee Hui Yeo (YH)

Department of Internal Medicine, Karsh Division of Gastroenterology and Hepatology, Cedars-Sinai Medical Center, Los Angeles, California, USA.

Hirsh Trivedi (H)

Department of Internal Medicine, Karsh Division of Gastroenterology and Hepatology, Cedars-Sinai Medical Center, Los Angeles, California, USA.
Comprehensive Transplant Center, Cedars-Sinai Medical Center, Los Angeles, California, USA.

Walid S Ayoub (WS)

Department of Internal Medicine, Karsh Division of Gastroenterology and Hepatology, Cedars-Sinai Medical Center, Los Angeles, California, USA.
Comprehensive Transplant Center, Cedars-Sinai Medical Center, Los Angeles, California, USA.

Alexander Kuo (A)

Department of Internal Medicine, Karsh Division of Gastroenterology and Hepatology, Cedars-Sinai Medical Center, Los Angeles, California, USA.
Comprehensive Transplant Center, Cedars-Sinai Medical Center, Los Angeles, California, USA.

Marc L Friedman (ML)

Department of Radiology, Cedars-Sinai Medical Center, Los Angeles, California, USA.

Kamya Sankar (K)

Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA.

Jun Gong (J)

Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA.

Arsen Osipov (A)

Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA.

Andrew Hendifar (A)

Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA.

Tsuyoshi Todo (T)

Comprehensive Transplant Center, Cedars-Sinai Medical Center, Los Angeles, California, USA.
Department of Surgery, Cedars-Sinai Medical Center, Los Angeles, California, USA.

Irene Kim (I)

Comprehensive Transplant Center, Cedars-Sinai Medical Center, Los Angeles, California, USA.
Department of Surgery, Cedars-Sinai Medical Center, Los Angeles, California, USA.

Georgios Voidonikolas (G)

Comprehensive Transplant Center, Cedars-Sinai Medical Center, Los Angeles, California, USA.
Department of Surgery, Cedars-Sinai Medical Center, Los Angeles, California, USA.

Todd V Brennan (TV)

Comprehensive Transplant Center, Cedars-Sinai Medical Center, Los Angeles, California, USA.
Department of Surgery, Cedars-Sinai Medical Center, Los Angeles, California, USA.

Steven A Wisel (SA)

Comprehensive Transplant Center, Cedars-Sinai Medical Center, Los Angeles, California, USA.
Department of Surgery, Cedars-Sinai Medical Center, Los Angeles, California, USA.

Justin Steggarda (J)

Comprehensive Transplant Center, Cedars-Sinai Medical Center, Los Angeles, California, USA.
Department of Surgery, Cedars-Sinai Medical Center, Los Angeles, California, USA.

Kambiz Kosari (K)

Comprehensive Transplant Center, Cedars-Sinai Medical Center, Los Angeles, California, USA.
Department of Surgery, Cedars-Sinai Medical Center, Los Angeles, California, USA.

Rola Saouaf (R)

Department of Radiology, Cedars-Sinai Medical Center, Los Angeles, California, USA.

Nicholas Nissen (N)

Comprehensive Transplant Center, Cedars-Sinai Medical Center, Los Angeles, California, USA.
Department of Surgery, Cedars-Sinai Medical Center, Los Angeles, California, USA.

Francis Yao (F)

Department of Medicine, Division of Gastroenterology, University of California, San Francisco, San Francisco, California, USA.
Department of Surgery, Division of Transplant Surgery, University of California, San Francisco, San Francisco, California, USA.

Neil Mehta (N)

Department of Medicine, Division of Gastroenterology, University of California, San Francisco, San Francisco, California, USA.

Ju Dong Yang (JD)

Department of Internal Medicine, Karsh Division of Gastroenterology and Hepatology, Cedars-Sinai Medical Center, Los Angeles, California, USA.
Comprehensive Transplant Center, Cedars-Sinai Medical Center, Los Angeles, California, USA.
Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA.

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questionsmedicales.fr › Eucaryotes › Animaux › Chordés › Vertébrés › Mammifères › Eutheria › Primates › Haplorhini › Catarrhini › Hominidae › Humains › Development and validation of a biomarker...
questionsmedicales.fr › Maladies de l'appareil digestif › Maladies du foie › Tumeurs du foie › Development and validation of a biomarker...
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questionsmedicales.fr › Procédures de chirurgie opératoire › Transplantation › Transplantation de tissu › Transplantation hépatique › Development and validation of a biomarker...
questionsmedicales.fr › Facteurs biologiques › Marqueurs biologiques › Marqueurs biologiques tumoraux › Alphafoetoprotéines › Development and validation of a biomarker...
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