Background: The Liver Imaging Reporting and Data System (LI-RADS) combines standardized terminology with a classification system for imaging findings in patients with HCC, therefore rendering diagnostic biopsy unnecessary in many cases. This retrospective study included 23 patients with a biopsy diagnosis of HCC, performed either before or after local interventional procedures, in order to evaluate the histopathologic changes induced by previous procedures and their potential influence on the response to immune therapy. Material and Methods: The study encompassed a cohort of patients diagnosed with Hepatocellular Carcinoma (HCC). Diagnosis was established via contrast-enhanced computer tomography or magnetic resonance imaging that identified LI-RADS-5 nodules in conjunction with historical liver disease and elevated alpha-fetoprotein (AFP) levels or via histological examination confirming positivity for glypican3, heat shock protein 70, and glutamine synthetase. The study detailed the liver disease etiology, LI-RADS scores, characteristics and dimensions of HCC nodules, serum AFP concentrations, Edmondson–Steiner grading, and the expression of programmed cell death ligand 1 (PD-L1) in the tumor cells. Results: Among the study’s cohort of Hepatocellular Carcinoma (HCC) patients, a portion had not received any prior treatments, while the remainder experienced local HCC recurrence following trans-arterial chemoembolization or radiofrequency ablation. Observations indicated elevated alpha-fetoprotein (AFP) levels in those who had not undergone any previous interventions, showing statistical significance. The Edmondson–Steiner classification predominantly identified grade III differentiation across patients, irrespective of their treatment history. Furthermore, an increase in intra-tumoral programmed cell death ligand 1 (PD-L1) expression was noted in patients who had not been subjected to previous therapies. Conclusion: Liver biopsy offers valuable insights for patients with Hepatocellular Carcinoma (HCC), assisting in the tailoring of immune therapy strategies, particularly in cases of recurrence following prior local interventions.
背景：肝脏影像报告和数据系统（LI-RADS）将标准化术语与肝细胞癌（HCC）患者影像学表现的分类系统相结合，从而在许多情况下避免了诊断性活检的必要性。本研究回顾性纳入了23例经活检确诊为HCC的患者，活检均在局部介入治疗前后进行，旨在评估既往治疗引起的组织病理学改变及其对免疫治疗反应的潜在影响。 材料与方法：本研究纳入一组经确诊的肝细胞癌（HCC）患者。诊断通过对比增强计算机断层扫描或磁共振成像确定LI-RADS-5类结节，并结合慢性肝病史及甲胎蛋白（AFP）水平升高；或通过组织学检查确认磷脂酰肌醇蛋白聚糖3、热休克蛋白70和谷氨酰胺合成酶阳性而确立。研究详细记录了肝病病因、LI-RADS评分、HCC结节特征与尺寸、血清AFP浓度、Edmondson–Steiner分级以及肿瘤细胞中程序性死亡配体1（PD-L1）的表达情况。 结果：在研究纳入的肝细胞癌（HCC）患者队列中，部分患者既往未接受任何治疗，其余患者则在经动脉化疗栓塞或射频消融后出现局部HCC复发。观察发现，未接受任何既往干预的患者甲胎蛋白（AFP）水平升高，且具有统计学显著性。Edmondson–Steiner分级显示，无论治疗史如何，患者均以III级分化为主。此外，在未接受既往治疗的患者中，观察到肿瘤内程序性死亡配体1（PD-L1）表达增加。 结论：对于肝细胞癌（HCC）患者，肝活检提供了宝贵信息，有助于制定个体化免疫治疗策略，特别是在既往局部干预后复发的病例中。
肿瘤(癌症)患者之家