Vessels That Encapsulate Tumor Clusters (VETC) Predict cTACE Response in Hepatocellular Carcinoma

Abstract

Chunyu Lin,1,2,* Yuan He,3,* Mengnan Liu,1,4 Aihua Wu,1 Jing Zhang,4 Shurong Li,5 Shuqi Li,6 Qinghua Cao,6 Fang Liu1,2 1State Key Laboratory of Organ Failure Research, Guangdong Provincial Key Laboratory of Viral Hepatitis Research, Department of Infectious Diseases, Department of Liver Tumor Center, Nanfang Hospital, Southern Medical University, Guangzhou, 51051, People’s Republic of China; 2Department of Oncology, Nanfang Hospital, Southern Medical University, Guangzhou, 51051, People’s Republic of China; 3Department of Radiotherapy, The First Affiliated Hospital of University of Science and Technology of China, Hefei, 23000, People’s Republic of China; 4Department of Radiology, Nanfang Hospital, Southern Medical University, Guangzhou, 51051, People’s Republic of China; 5Department of Radiology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, 51008, People’s Republic of China; 6Department of Pathology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, 51008, People’s Republic of China*These authors contributed equally to this workCorrespondence: Qinghua Cao, Department of Pathology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, 51008, People’s Republic of China, Email [email protected] Fang Liu, Department of Oncology, Nanfang Hospital, Southern Medical University, Guangzhou, 51051, People’s Republic of China, Email [email protected]: To investigate the correlation between hepatocellular carcinoma (HCC) pathological types and conventional transarterial chemoembolization (cTACE), and to evaluate the predictive value of the pathological types for efficacy of cTACE.Methods: We investigated 186 naive HCC patients from 2 hospitals, including 63 patients with recurrence after surgical resection, and 123 unresectable cases, who underwent at least one cTACE procedure as the first treatment. All patients were histologically diagnosed with HCC by surgical resection and/or liver biopsy. Lipiodol deposition rate, ORR (objective response rate), PFS (progression-free survival), OS (overall survival) were compared among different HCC pathological types.Results: This study evaluated 186 naive HCC patients and 189 tumor nodules. Vessels that encapsulate tumor clusters (VETC), macrotrabecular-massive (MTM), CK19-positive types were identified in 38% (72/189), 40% (76/189), and 28% (53/189) of the whole cohort, respectively. VETC, MTM and CK19-negative HCCs derived significantly better lipiodol deposition rate and ORR. cTACE prolonged the PFS of VETC and CK19-negative HCCs compared with non-VETC and CK19-positive HCCs in the recurrence, liver biopsy and combining whole cohorts, whereas the OSs of different pathological types were not significantly different. Multivariate analysis showed that VETC (OR, 4.671, 95% CI [1.954, 11.166], P< 0.001) and CK19-positive type (OR, 0.127, 95% CI [0.044, 0.362], P< 0.001) were independent predictive factors for the first cTACE response. However, only VETC type was significantly associated with the second cTACE response in multivariate analysis (OR, 3.31, 95% CI [1.24, 8.83], P=0.017), suggesting that VETC might be a more useful predictor of cTACE response.Conclusion: Our study suggests that VETC is an effective predictor of cTACE response in patients with HCC.Keywords: hepatocellular carcinoma, vessels that encapsulate tumor clusters, CK19-positive, conventional transarterial chemoembolization

Keywords

• hepatocellular carcinoma
• vessels that encapsulate tumor clusters
• ck19-positive
• conventional transarterial chemoembolization