Preoperative prediction of cholangiocyte phenotype hepatocellular carcinoma on contrast-enhanced MRI and the prognostic implication after hepatectomy
Abstract Background Hepatocellular carcinoma (HCC) expressing cytokeratin (CK) 7 or CK19 has a cholangiocyte phenotype that stimulates HCC proliferation, metastasis, and sorafenib therapy resistance This study aims to noninvasively predict cholangiocyte phenotype-positive HCC and assess its prognosi...
| Main Authors: | , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
SpringerOpen
2023-11-01
|
| Series: | Insights into Imaging |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s13244-023-01539-x |
| _version_ | 1827710662843826176 |
|---|---|
| author | Yidi Chen Jie Chen Chongtu Yang Yuanan Wu Hong Wei Ting Duan Zhen Zhang Liling Long Hanyu Jiang Bin Song |
| author_facet | Yidi Chen Jie Chen Chongtu Yang Yuanan Wu Hong Wei Ting Duan Zhen Zhang Liling Long Hanyu Jiang Bin Song |
| author_sort | Yidi Chen |
| collection | DOAJ |
| description | Abstract Background Hepatocellular carcinoma (HCC) expressing cytokeratin (CK) 7 or CK19 has a cholangiocyte phenotype that stimulates HCC proliferation, metastasis, and sorafenib therapy resistance This study aims to noninvasively predict cholangiocyte phenotype-positive HCC and assess its prognosis after hepatectomy. Methods Between January 2010 and May 2022, preoperative contrast-enhanced MRI was performed on consecutive patients who underwent hepatectomy and had pathologically confirmed solitary HCC. Two abdominal radiologists separately assessed the MRI features. A predictive model for cholangiocyte phenotype HCC was created using logistic regression analysis and five-fold cross-validation. A receiver operating characteristic curve was used to calculate the model performance. Kaplan–Meier and log-rank methods were used to evaluate survival outcomes. Results In total, 334 patients were included in this retrospective study. Four contrast-enhanced MRI features, including “rim arterial phase hyperenhancement” (OR = 5.9, 95% confidence interval [CI]: 2.9–12.0, 10 points), “nodule in nodule architecture” (OR = 3.5, 95% CI: 2.1–5.9, 7 points), “non-smooth tumor margin” (OR = 1.6, 95% CI: 0.8–2.9, 3 points), and “non-peripheral washout” (OR = 0.6, 95% CI: 0.3–1.0, − 3 points), were assigned to the cholangiocyte phenotype HCC prediction model. The area under the curves for the training and independent validation set were 0.76 and 0.73, respectively. Patients with model-predicted cholangiocyte phenotype HCC demonstrated lower rates of recurrence-free survival (RFS) and overall survival (OS) after hepatectomy, with an estimated median RFS and OS of 926 vs. 1565 days (p < 0.001) and 1504 vs. 2960 days (p < 0.001), respectively. Conclusions Contrast-enhanced MRI features can be used to predict cholangiocyte phenotype-positive HCC. Patients with pathologically confirmed or MRI model-predicted cholangiocyte phenotype HCC have a worse prognosis after hepatectomy. Critical relevance statement Four contrast-enhanced MRI features were significantly associated with cholangiocyte phenotype HCC and a worse prognosis following hepatectomy; these features may assist in predicting prognosis after surgery and improve personalized treatment decision-making. Key points • Four contrast-enhanced MRI features were significantly associated with cholangiocyte phenotype HCC. • A noninvasive cholangiocyte phenotype HCC predictive model was established based on MRI features. • Patients with cholangiocyte phenotype HCC demonstrated a worse prognosis following hepatic resection. Graphical Abstract |
| first_indexed | 2024-03-10T17:43:03Z |
| format | Article |
| id | doaj.art-afbcd18337e245b8af4c7ac32fdae5ad |
| institution | Directory Open Access Journal |
| issn | 1869-4101 |
| language | English |
| last_indexed | 2024-03-10T17:43:03Z |
| publishDate | 2023-11-01 |
| publisher | SpringerOpen |
| record_format | Article |
| series | Insights into Imaging |
| spelling | doaj.art-afbcd18337e245b8af4c7ac32fdae5ad2023-11-20T09:39:00ZengSpringerOpenInsights into Imaging1869-41012023-11-0114111410.1186/s13244-023-01539-xPreoperative prediction of cholangiocyte phenotype hepatocellular carcinoma on contrast-enhanced MRI and the prognostic implication after hepatectomyYidi Chen0Jie Chen1Chongtu Yang2Yuanan Wu3Hong Wei4Ting Duan5Zhen Zhang6Liling Long7Hanyu Jiang8Bin Song9Department of Radiology, West China Hospital, Sichuan UniversityDepartment of Radiology, West China Hospital, Sichuan UniversityDepartment of Radiology, West China Hospital, Sichuan UniversityBig Data Research Center, University of Electronic Science and Technology of ChinaDepartment of Radiology, West China Hospital, Sichuan UniversityDepartment of Radiology, West China Hospital, Sichuan UniversityDepartment of Radiology, West China Hospital, Sichuan UniversityDepartment of Radiology, the First Affiliated Hospital of Guangxi Medical UniversityDepartment of Radiology, West China Hospital, Sichuan UniversityDepartment of Radiology, West China Hospital, Sichuan UniversityAbstract Background Hepatocellular carcinoma (HCC) expressing cytokeratin (CK) 7 or CK19 has a cholangiocyte phenotype that stimulates HCC proliferation, metastasis, and sorafenib therapy resistance This study aims to noninvasively predict cholangiocyte phenotype-positive HCC and assess its prognosis after hepatectomy. Methods Between January 2010 and May 2022, preoperative contrast-enhanced MRI was performed on consecutive patients who underwent hepatectomy and had pathologically confirmed solitary HCC. Two abdominal radiologists separately assessed the MRI features. A predictive model for cholangiocyte phenotype HCC was created using logistic regression analysis and five-fold cross-validation. A receiver operating characteristic curve was used to calculate the model performance. Kaplan–Meier and log-rank methods were used to evaluate survival outcomes. Results In total, 334 patients were included in this retrospective study. Four contrast-enhanced MRI features, including “rim arterial phase hyperenhancement” (OR = 5.9, 95% confidence interval [CI]: 2.9–12.0, 10 points), “nodule in nodule architecture” (OR = 3.5, 95% CI: 2.1–5.9, 7 points), “non-smooth tumor margin” (OR = 1.6, 95% CI: 0.8–2.9, 3 points), and “non-peripheral washout” (OR = 0.6, 95% CI: 0.3–1.0, − 3 points), were assigned to the cholangiocyte phenotype HCC prediction model. The area under the curves for the training and independent validation set were 0.76 and 0.73, respectively. Patients with model-predicted cholangiocyte phenotype HCC demonstrated lower rates of recurrence-free survival (RFS) and overall survival (OS) after hepatectomy, with an estimated median RFS and OS of 926 vs. 1565 days (p < 0.001) and 1504 vs. 2960 days (p < 0.001), respectively. Conclusions Contrast-enhanced MRI features can be used to predict cholangiocyte phenotype-positive HCC. Patients with pathologically confirmed or MRI model-predicted cholangiocyte phenotype HCC have a worse prognosis after hepatectomy. Critical relevance statement Four contrast-enhanced MRI features were significantly associated with cholangiocyte phenotype HCC and a worse prognosis following hepatectomy; these features may assist in predicting prognosis after surgery and improve personalized treatment decision-making. Key points • Four contrast-enhanced MRI features were significantly associated with cholangiocyte phenotype HCC. • A noninvasive cholangiocyte phenotype HCC predictive model was established based on MRI features. • Patients with cholangiocyte phenotype HCC demonstrated a worse prognosis following hepatic resection. Graphical Abstracthttps://doi.org/10.1186/s13244-023-01539-xHepatocellular carcinomaMagnetic resonance imagingCytokeratin 7Cytokeratin 19Cholangiocyte phenotype |
| spellingShingle | Yidi Chen Jie Chen Chongtu Yang Yuanan Wu Hong Wei Ting Duan Zhen Zhang Liling Long Hanyu Jiang Bin Song Preoperative prediction of cholangiocyte phenotype hepatocellular carcinoma on contrast-enhanced MRI and the prognostic implication after hepatectomy Insights into Imaging Hepatocellular carcinoma Magnetic resonance imaging Cytokeratin 7 Cytokeratin 19 Cholangiocyte phenotype |
| title | Preoperative prediction of cholangiocyte phenotype hepatocellular carcinoma on contrast-enhanced MRI and the prognostic implication after hepatectomy |
| title_full | Preoperative prediction of cholangiocyte phenotype hepatocellular carcinoma on contrast-enhanced MRI and the prognostic implication after hepatectomy |
| title_fullStr | Preoperative prediction of cholangiocyte phenotype hepatocellular carcinoma on contrast-enhanced MRI and the prognostic implication after hepatectomy |
| title_full_unstemmed | Preoperative prediction of cholangiocyte phenotype hepatocellular carcinoma on contrast-enhanced MRI and the prognostic implication after hepatectomy |
| title_short | Preoperative prediction of cholangiocyte phenotype hepatocellular carcinoma on contrast-enhanced MRI and the prognostic implication after hepatectomy |
| title_sort | preoperative prediction of cholangiocyte phenotype hepatocellular carcinoma on contrast enhanced mri and the prognostic implication after hepatectomy |
| topic | Hepatocellular carcinoma Magnetic resonance imaging Cytokeratin 7 Cytokeratin 19 Cholangiocyte phenotype |
| url | https://doi.org/10.1186/s13244-023-01539-x |
| work_keys_str_mv | AT yidichen preoperativepredictionofcholangiocytephenotypehepatocellularcarcinomaoncontrastenhancedmriandtheprognosticimplicationafterhepatectomy AT jiechen preoperativepredictionofcholangiocytephenotypehepatocellularcarcinomaoncontrastenhancedmriandtheprognosticimplicationafterhepatectomy AT chongtuyang preoperativepredictionofcholangiocytephenotypehepatocellularcarcinomaoncontrastenhancedmriandtheprognosticimplicationafterhepatectomy AT yuananwu preoperativepredictionofcholangiocytephenotypehepatocellularcarcinomaoncontrastenhancedmriandtheprognosticimplicationafterhepatectomy AT hongwei preoperativepredictionofcholangiocytephenotypehepatocellularcarcinomaoncontrastenhancedmriandtheprognosticimplicationafterhepatectomy AT tingduan preoperativepredictionofcholangiocytephenotypehepatocellularcarcinomaoncontrastenhancedmriandtheprognosticimplicationafterhepatectomy AT zhenzhang preoperativepredictionofcholangiocytephenotypehepatocellularcarcinomaoncontrastenhancedmriandtheprognosticimplicationafterhepatectomy AT lilinglong preoperativepredictionofcholangiocytephenotypehepatocellularcarcinomaoncontrastenhancedmriandtheprognosticimplicationafterhepatectomy AT hanyujiang preoperativepredictionofcholangiocytephenotypehepatocellularcarcinomaoncontrastenhancedmriandtheprognosticimplicationafterhepatectomy AT binsong preoperativepredictionofcholangiocytephenotypehepatocellularcarcinomaoncontrastenhancedmriandtheprognosticimplicationafterhepatectomy |