肝细胞癌术后早期复发的高危因素及预测方法
DOI: 10.12449/JCH241028
利益冲突声明:本文不存在任何利益冲突。
作者贡献声明:鲁叶负责撰写论文;韩少山负责拟定写作思路;刘青光指导撰写文章并最后定稿。
High-risk factors for early postoperative recurrence of hepatocellular carcinoma and related prediction methods
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摘要: 肝细胞癌(HCC)是一种发病率、病死率较高的恶性肿瘤,尽管手术切除是可能治愈的方法,其预后依旧受到高复发率的影响。早期复发(术后2年内)被定义为真正的复发,通常由原发肿瘤肝内扩散引起。HCC早期复发的预后较晚期复发差。因此,充分了解早期复发的高危因素及预测方法对术前治疗方案的选择、术后随访及预后预测至关重要。本文旨在对HCC术后早期复发高危因素及预测方法进行综述。Abstract: Hepatocellular carcinoma (HCC) is a malignant tumor with high incidence and mortality rates, and although surgical resection is a possible method for cure, the prognosis of HCC is still affected by its high recurrence rate. Early recurrence (within 2 years after surgery) is defined as true recurrence and is usually caused by the intrahepatic spread of primary tumor. Early recurrence of HCC tends to have a poorer prognosis than late recurrence. Therefore, it is of great importance to fully understand the high-risk factors and prediction methods for early recurrence, which is essential to the selection of preoperative treatment regimens, postoperative follow-up, and prognosis. This article reviews the high-risk factors and prediction methods for early recurrence of HCC after surgery.
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Key words:
- Carcinoma, Hepatocellular /
- Hepatectomy /
- Recurrence /
- Risk Factors
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[1] RUMGAY H, ARNOLD M, FERLAY J, et al. Global burden of primary liver cancer in 2020 and predictions to 2040[J]. J Hepatol, 2022, 77( 6): 1598- 1606. DOI: 10.1016/j.jhep.2022.08.021. [2] SAGNELLI E, MACERA M, RUSSO A, et al. Epidemiological and etiological variations in hepatocellular carcinoma[J]. Infection, 2020, 48( 1): 7- 17. DOI: 10.1007/s15010-019-01345-y. [3] DING JL, WEN ZL. Survival improvement and prognosis for hepatocellular carcinoma: Analysis of the SEER database[J]. BMC Cancer, 2021, 21( 1): 1157. DOI: 10.1186/s12885-021-08904-3. [4] PINNA AD, TIAN Y, MAZZAFERRO V, et al. Liver transplantation and hepatic resection can achieve cure for hepatocellular carcinoma[J]. Ann Surg, 2018, 268( 5): 868- 875. DOI: 10.1097/SLA.0000000000002889. [5] NEVOLA R, RUOCCO R, CRISCUOLO L, et al. Predictors of early and late hepatocellular carcinoma recurrence[J]. World J Gastroenterol, 2023, 29( 8): 1243- 1260. DOI: 10.3748/wjg.v29.i8.1243. [6] YAN WT, LI C, YAO LQ, et al. Predictors and long-term prognosis of early and late recurrence for patients undergoing hepatic resection of hepatocellular carcinoma: A large-scale multicenter study[J]. Hepatobiliary Surg Nutr, 2023, 12( 2): 155- 168. DOI: 10.21037/hbsn-21-288. [7] SHIM JH, JUN MJ, HAN S, et al. Prognostic nomograms for prediction of recurrence and survival after curative liver resection for hepatocellular carcinoma[J]. Ann Surg, 2015, 261( 5): 939- 946. DOI: 10.1097/SLA.0000000000000747. [8] WANG XB, ZHAO YQ, BAI T, et al. Serum immune biomarker levels combined with hepatitis B virus infection status predict early recurrence of early-stage hepatocellular carcinoma with microvascular invasion after liver resection[J]. Acta Chir Belg, 2023, 123( 6): 659- 665. DOI: 10.1080/00015458.2022.2136051. [9] HE LY, XIA ZJ, ZHANG XY, et al. Tenofovir versus entecavir on the prognosis of hepatitis B-related hepatocellular carcinoma after surgical resection: A randomised controlled trial[J]. Int J Surg, 2023, 109( 10): 3032- 3041. DOI: 10.1097/JS9.0000000000000554. [10] ZHENG J, CAI JY, LI H, et al. Neutrophil to lymphocyte ratio and platelet to lymphocyte ratio as prognostic predictors for hepatocellular carcinoma patients with various treatments: A meta-analysis and systematic review[J]. Cell Physiol Biochem, 2017, 44( 3): 967- 981. DOI: 10.1159/000485396. [11] XU CH, WU FF, DU LL, et al. Significant association between high neutrophil-lymphocyte ratio and poor prognosis in patients with hepatocellular carcinoma: A systematic review and meta-analysis[J]. Front Immunol, 2023, 14: 1211399. DOI: 10.3389/fimmu.2023.1211399. [12] ANG SF, NG ES, LI HH, et al. The Singapore Liver Cancer Recurrence(SLICER) Score for relapse prediction in patients with surgically resected hepatocellular carcinoma[J]. PLoS One, 2015, 10( 4): e0118658. DOI: 10.1371/journal.pone.0118658. [13] HORIE H, OGISO S, YOH T, et al. Albumin-bilirubin score at post-hepatectomy hepatocellular carcinoma recurrence: Impact on survival and association with post-hepatectomy liver failure[J]. J Gastrointest Surg, 2023, 27( 11): 2414- 2423. DOI: 10.1007/s11605-023-05802-w. [14] YANG CK, WU XY, LIU JY, et al. Nomogram based on platelet-albumin-bilirubin for predicting tumor recurrence after surgery in alpha-fetoprotein-negative hepatocellular carcinoma patients[J]. J Hepatocell Carcinoma, 2023, 10: 43- 55. DOI: 10.2147/JHC.S396433. [15] WU BQ, HU XS, JIN H, et al. Albumin-bilirubin and platelet-albumin-bilirubin grades for hepatitis B-associated hepatocellular carcinoma in Child-Pugh A patients treated with radical surgery: A retrospective observational study[J]. Medicine, 2019, 98( 43): e17394. DOI: 10.1097/MD.0000000000017394. [16] LIU PH, HSU CY, HSIA CY, et al. ALBI and PALBI grade predict survival for HCC across treatment modalities and BCLC stages in the MELD Era[J]. J Gastroenterol Hepatol, 2017, 32( 4): 879- 886. DOI: 10.1111/jgh.13608. [17] LUO HM, LI C, CHEN LP. Preoperative albumin-bilirubin grade combined with aspartate aminotransferase-to-platelet count ratio index predict outcomes of patients with hepatocellular carcinoma within Milan criteria after liver resection[J]. Biosci Trends, 2019, 13( 2): 176- 181. DOI: 10.5582/bst.2019.01088. [18] YUN SO, KIM JM, RHU J, et al. Fibrosis-4 index, a predictor for prognosis of hepatocellular carcinoma patients after curative hepatectomy even in hepatitis B virus dominant populations[J]. Ann Surg Treat Res, 2023, 104( 4): 195- 204. DOI: 10.4174/astr.2023.104.4.195. [19] LU MT, QU Q, XU L, et al. Prediction for aggressiveness and postoperative recurrence of hepatocellular carcinoma using gadoxetic acid-enhanced magnetic resonance imaging[J]. Acad Radiol, 2023, 30( 5): 841- 852. DOI: 10.1016/j.acra.2022.12.018. [20] KOBAYASHI M, IKEDA K, KAWAMURA Y, et al. High serum des-gamma-carboxy prothrombin level predicts poor prognosis after radiofrequency ablation of hepatocellular carcinoma[J]. Cancer, 2009, 115( 3): 571- 580. DOI: 10.1002/cncr.24031. [21] WANG MD, SUN LY, QIAN GJ, et al. Prothrombin induced by vitamin K Absence-Ⅱ versus alpha-fetoprotein in detection of both resectable hepatocellular carcinoma and early recurrence after curative liver resection: A retrospective cohort study[J]. Int J Surg, 2022, 105: 106843. DOI: 10.1016/j.ijsu.2022.106843. [22] RYU T, TAKAMI Y, WADA Y, et al. Double- and triple-positive tumor markers predict early recurrence and poor survival in patients with hepatocellular carcinoma within the Milan criteria and child-pugh class A[J]. J Gastrointest Surg, 2017, 21( 6): 957- 966. DOI: 10.1007/s11605-017-3394-1. [23] JUNG SM, KIM JM, CHOI GS, et al. Characteristics of early recurrence after curative liver resection for solitary hepatocellular carcinoma[J]. J Gastrointest Surg, 2019, 23( 2): 304- 311. DOI: 10.1007/s11605-018-3927-2. [24] XU XF, DIAO YK, ZENG YY, et al. Association of severity in the grading of microvascular invasion with long-term oncological prognosis after liver resection for early-stage hepatocellular carcinoma: A multicenter retrospective cohort study from a hepatitis B virus-endemic area[J]. Int J Surg, 2023, 109( 4): 841- 849. DOI: 10.1097/JS9.0000000000000325. [25] ZHOU L, RUI JA, ZHOU WX, et al. Edmondson-Steiner grade: A crucial predictor of recurrence and survival in hepatocellular carcinoma without microvascular invasio[J]. Pathol Res Pract, 2017, 213( 7): 824- 830. DOI: 10.1016/j.prp.2017.03.002. [26] YOON JH, CHOI SK, CHO SB, et al. Early extrahepatic recurrence as a pivotal factor for survival after hepatocellular carcinoma resection: A 15-year observational study[J]. World J Gastroenterol, 2022, 28( 36): 5351- 5363. DOI: 10.3748/wjg.v28.i36.5351. [27] ZHANG K, TAO CC, SIQIN TN, et al. Establishment, validation and evaluation of predictive model for early relapse after R0 resection in hepatocellular carcinoma patients with microvascular invasion[J]. J Transl Med, 2021, 19( 1): 293. DOI: 10.1186/s12967-021-02940-0. [28] HOU JW, ZHAO RC, XIA WY, et al. PD-L1-mediated gasdermin C expression switches apoptosis to pyroptosis in cancer cells and facilitates tumour necrosis[J]. Nat Cell Biol, 2020, 22( 10): 1264- 1275. DOI: 10.1038/s41556-020-0575-z. [29] CHONG HH, GONG YD, PAN XP, et al. Peritumoral dilation radiomics of gadoxetate disodium-enhanced MRI excellently predicts early recurrence of hepatocellular carcinoma without macrovascular invasion after hepatectomy[J]. J Hepatocell Carcinoma, 2021, 8: 545- 563. DOI: 10.2147/JHC.S309570. [30] HWANG S, LEE YJ, KIM KH, et al. The impact of tumor size on long-term survival outcomes after resection of solitary hepatocellular carcinoma: Single-institution experience with 2558 patients[J]. J Gastrointest Surg, 2015, 19( 7): 1281- 1290. DOI: 10.1007/s11605-015-2849-5. [31] LAI Y, LEE JC, HUNG HC, et al. Models to predict disease-free survival for hepatocellular carcinoma patients with surgical resections[J]. J Surg Oncol, 2020, 122( 7): 1444- 1452. DOI: 10.1002/jso.26169. [32] LI WF, LIU YW, WANG CC, et al. Radiographic tumor burden score is useful for stratifying the overall survival of hepatocellular carcinoma patients undergoing resection at different Barcelona Clinic Liver Cancer stages[J]. Langenbecks Arch Surg, 2023, 408( 1): 169. DOI: 10.1007/s00423-023-02869-6. [33] WEI H, JIANG HY, ZHENG TY, et al. LI-RADS category 5 hepatocellular carcinoma: Preoperative gadoxetic acid-enhanced MRI for early recurrence risk stratification after curative resection[J]. Eur Radiol, 2021, 31( 4): 2289- 2302. DOI: 10.1007/s00330-020-07303-9. [34] ARIIZUMI S, KITAGAWA K, KOTERA Y, et al. A non-smooth tumor margin in the hepatobiliary phase of gadoxetic acid disodium(Gd-EOB-DTPA)-enhanced magnetic resonance imaging predicts microscopic portal vein invasion, intrahepatic metastasis, and early recurrence after hepatectomy in patients with hepatocellular carcinoma[J]. J Hepatobiliary Pancreat Sci, 2011, 18( 4): 575- 585. DOI: 10.1007/s00534-010-0369-y. [35] XIA WZ, PENG TY, GUAN RG, et al. Development of a novel prognostic nomogram for the early recurrence of liver cancer after curative hepatectomy[J]. Ann Transl Med, 2021, 9( 20): 1541. DOI: 10.21037/atm-21-4837. [36] WEI H, JIANG HY, QIN Y, et al. Comparison of a preoperative MR-based recurrence risk score versus the postoperative score and four clinical staging systems in hepatocellular carcinoma: A retrospective cohort study[J]. Eur Radiol, 2022, 32( 11): 7578- 7589. DOI: 10.1007/s00330-022-08811-6. [37] CHOI JY, LEE JM, SIRLIN CB. CT and MR imaging diagnosis and staging of hepatocellular carcinoma: Part Ⅱ. Extracellular agents, hepatobiliary agents, and ancillary imaging features[J]. Radiology, 2014, 273( 1): 30- 50. DOI: 10.1148/radiol.14132362. [38] WANG LY, FENG B, LI DF, et al. Risk stratification of solitary hepatocellular carcinoma ≤5 cm without microvascular invasion: Prognostic values of MR imaging features based on LI-RADS and clinical parameters[J]. Eur Radiol, 2023, 33( 5): 3592- 3603. DOI: 10.1007/s00330-023-09484-5. [39] YANG HL, HAN P, HUANG MT, et al. The role of gadoxetic acid-enhanced MRI features for predicting microvascular invasion in patients with hepatocellular carcinoma[J]. Abdom Radiol, 2022, 47( 3): 948- 956. DOI: 10.1007/s00261-021-03392-2. [40] CHEN JB, ZHOU J, KUANG SC, et al. Liver imaging reporting and data system category 5: MRI predictors of microvascular invasion and recurrence after hepatectomy for hepatocellular carcinoma[J]. AJR Am J Roentgenol, 2019, 213( 4): 821- 830. DOI: 10.2214/AJR.19.21168. [41] WEI H, JIANG HY, LIU XJ, et al. Can LI-RADS imaging features at gadoxetic acid-enhanced MRI predict aggressive features on pathology of single hepatocellular carcinoma?[J]. Eur J Radiol, 2020, 132: 109312. DOI: 10.1016/j.ejrad.2020.109312. [42] JIANG HY, WEI H, YANG T, et al. VICT2 trait: Prognostic alternative to peritumoral hepatobiliary phase hypointensity in HCC[J]. Radiology, 2023, 307( 2): e221835. DOI: 10.1148/radiol.221835. [43] TSILIMIGRAS DI, SAHARA K, MORIS D, et al. Effect of surgical margin width on patterns of recurrence among patients undergoing R0 hepatectomy for T1 hepatocellular carcinoma: An international multi-institutional analysis[J]. J Gastrointest Surg, 2020, 24( 7): 1552- 1560. DOI: 10.1007/s11605-019-04275-0. [44] ENDO Y, MUNIR MM, WOLDESENBET S, et al. Impact of surgical margin width on prognosis following resection of hepatocellular carcinoma varies on the basis of preoperative alpha-feto protein and tumor burden score[J]. Ann Surg Oncol, 2023, 30( 11): 6581- 6589. DOI: 10.1245/s10434-023-13825-5. [45] LIU QG, SONG T, WANG HH. Re-understanding of surgical resection techniques for liver cancer[J]. Chin J Dig Surg, 2024, 23( 1): 75- 79. DOI: 10.3760/cma.j.cn115610-20231214-00253.刘青光, 宋涛, 王欢欢. 肝癌外科手术切除技术的再认识[J]. 中华消化外科杂志, 2024, 23( 1): 75- 79. DOI: 10.3760/cma.j.cn115610-20231214-00253. [46] LAZZARA C, NAVARRA G, LAZZARA S, et al. Does the margin width influence recurrence rate in liver surgery for hepatocellular carcinoma smaller than 5 cm?[J]. Eur Rev Med Pharmacol Sci, 2017, 21( 3): 523- 529. [47] KANG KJ, AHN KS. Anatomical resection of hepatocellular carcinoma: A critical review of the procedure and its benefits on survival[J]. World J Gastroenterol, 2017, 23( 7): 1139- 1146. DOI: 10.3748/wjg.v23.i7.1139. [48] HANG T, LI ZY, CHEN MY, et al. Perioperative efficacy analysis of robotic surgical system assisted anatomic and non-anatomic hepatectomy[J]. Chin J Dig Surg, 2023, 22( 4): 497- 504. DOI: 10.3760/cma.j.cn115610-20230204-000041.杭天, 李哲勇, 陈鸣宇, 等. 机器人手术系统辅助解剖性与非解剖性肝切除术的围手术期疗效分析[J]. 中华消化外科杂志, 2023, 22( 4): 497- 504. DOI: 10.3760/cma.j.cn115610-20230204-000041. [49] TANG SC, ZHANG KL, LIN KY, et al. A multicenter propensity score analysis of significance of hepatic resection type for early-stage hepatocellular carcinoma[J]. Hepatol Int, 2024, 18( 2): 623- 635. DOI: 10.1007/s12072-023-10602-0. [50] GAO WY, WANG WT, SONG DJ, et al. A predictive model integrating deep and radiomics features based on gadobenate dimeglumine-enhanced MRI for postoperative early recurrence of hepatocellular carcinoma[J]. Radiol Med, 2022, 127( 3): 259- 271. DOI: 10.1007/s11547-021-01445-6. [51] CAO XS, YANG HR, LUO X, et al. A cox nomogram for assessing recurrence free survival in hepatocellular carcinoma following surgical resection using dynamic contrast-enhanced MRI radiomics[J]. J Magn Reson Imaging, 2023, 58( 6): 1930- 1941. DOI: 10.1002/jmri.28725. [52] KSIĄŻKIEWICZ M, MARKIEWICZ A, ZACZEK AJ. Epithelial-mesenchymal transition: A hallmark in metastasis formation linking circulating tumor cells and cancer stem cells[J]. Pathobiology, 2012, 79( 4): 195- 208. DOI: 10.1159/000337106. [53] LU Z, NI HH, YANG XH, et al. Prognostic potential of preoperative circulating tumor cells to predict the early progression recurrence in hepatocellular carcinoma patients after hepatectomy[J]. BMC Cancer, 2023, 23( 1): 1150. DOI: 10.1186/s12885-023-11629-0. [54] ZHU GQ, LIU WR, TANG Z, et al. Serial circulating tumor DNA to predict early recurrence in patients with hepatocellular carcinoma: A prospective study[J]. Mol Oncol, 2022, 16( 2): 549- 561. DOI: 10.1002/1878-0261.13105. [55] WEI YN, ZHANG Q, AN L, et al. Serum exosomal microRNA-370-3p and microRNA-196a-5p are potential biomarkers for the diagnosis and prognosis of hepatocellular carcinoma[J]. Folia Histochem Cytobiol, 2022, 60( 3): 215- 225. DOI: 10.5603/FHC.a2022.0019. [56] ZENG YL, HU SY, LUO Y, et al. Exosome cargos as biomarkers for diagnosis and prognosis of hepatocellular carcinoma[J]. Pharmaceutics, 2023, 15( 9): 2365. DOI: 10.3390/pharmaceutics15092365. [57] LIU WM, SONG KR, ZHENG W, et al. Hepatobiliary phase features of preoperative gadobenate-enhanced MR can predict early recurrence of hepatocellular carcinoma in patients who underwent anatomical hepatectomy[J]. Front Oncol, 2022, 12: 862967. DOI: 10.3389/fonc.2022.862967. [58] YAN M, ZHANG X, ZHANG B, et al. Deep learning nomogram based on Gd-EOB-DTPA MRI for predicting early recurrence in hepatocellular carcinoma after hepatectomy[J]. Eur Radiol, 2023, 33( 7): 4949- 4961. DOI: 10.1007/s00330-023-09419-0. [59] HE YZ, LUO LH, SHAN RF, et al. Development and validation of a nomogram for predicting postoperative early relapse and survival in hepatocellular carcinoma[J]. J Natl Compr Canc Netw, 2023, 22( 1D): e237069. DOI: 10.6004/jnccn.2023.7069. [60] LU Y, WANG H, LI C, et al. Preoperative and postoperative MRI-based models versus clinical staging systems for predicting early recurrence in hepatocellular carcinoma[J]. Eur J Surg Oncol, 2024, 50( 9): 108476. DOI: 10.1016/j.ejso.2024.108476.
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