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

Chunyu Lin; Yuan He; Mengnan Liu; Aihua Wu; Jing Zhang; Shurong Li; Shuqi Li; Qinghua Cao; Fang Liu

doi:10.2147/JHC.S395903

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

J Hepatocell Carcinoma. 2023 Mar 7:10:383-397. doi: 10.2147/JHC.S395903. eCollection 2023.

Authors

Chunyu Lin^#^{1

2}, Yuan He^#³, Mengnan Liu^{1

4}, Aihua Wu¹, Jing Zhang⁴, Shurong Li⁵, Shuqi Li⁶, Qinghua Cao⁶, Fang Liu^{1

2}

Affiliations

¹ State 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.
² Department of Oncology, Nanfang Hospital, Southern Medical University, Guangzhou, 51051, People's Republic of China.
³ Department of Radiotherapy, The First Affiliated Hospital of University of Science and Technology of China, Hefei, 23000, People's Republic of China.
⁴ Department of Radiology, Nanfang Hospital, Southern Medical University, Guangzhou, 51051, People's Republic of China.
⁵ Department of Radiology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, 51008, People's Republic of China.
⁶ Department of Pathology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, 51008, People's Republic of China.

^# Contributed equally.

Abstract

Background: 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: CK19-positive; conventional transarterial chemoembolization; hepatocellular carcinoma; vessels that encapsulate tumor clusters.

Grants and funding

This study was supported by National Natural Science Foundation of China (Grant Nos. 81802431, 81972516), Natural Science Foundation of Guangdong Province (Grant No. 2021A1515012448); President Foundation of Nanfang Hospital, Southern Medical University (Grant No. 2018B012).