Contrast-Enhanced Ultrasound Liver Imaging Reporting and Data System in Hepatocellular Carcinoma ≤5 cm: Biological Characteristics and Patient Outcomes.

Introduction: The present study aimed to evaluate the influence of biological characteristics of hepatocellular carcinoma (HCC) on the Liver Imaging Reporting and Data System (LI-RADS) v2017 category of contrast-enhanced ultrasound (CEUS) in patients with high risk and compare the outcomes among different categories after radical resection. Methods: Between June 2017 and December 2020, standardized CEUS data of liver nodules were prospectively collected from multiple centers across China. We conducted a retrospective analysis of the prospectively collected data on HCCs measuring no more than 5 cm, as diagnosed by pathology. LI-RADS categories were assigned after thorough evaluation of CEUS features. Then, CEUS LI-RADS categories and major features were compared in different differentiation, Ki-67, and microvascular invasion (MVI) statuses. Differences in recurrence-free survival (RFS) among different LI-RADS categories were further analyzed. Results: A total of 293 HCC nodules in 293 patients were included. This study revealed significant differences in the CEUS LI-RADS category of HCCs among differentiation (p < 0.001) and levels of Ki-67 (p = 0.01) and that poor differentiation (32.7% in LR-M, 12% in LR-5, and 6.2% in LR-4) (p < 0.001) and high level of Ki-67 (median value 30%) were more frequently classified into the LR-M category, whereas well differentiation (37.5% in LR-4, 15.1% in LR-5, and 11.5% in LR-M) and low levels of Ki-67 (median value 11%) were more frequently classified into the LR-4 category. No significant differences were found between MVI and CEUS LI-RADS categories (p > 0.05). With a median follow-up of 23 months, HCCs assigned to different CEUS LI-RADS classes showed no significant differences in RFS after resection. Conclusions: Biological characteristics of HCC, including differentiation and level of Ki-67 expression, could influence major features of CEUS and impact the CEUS LI-RADS category. HCCs in different CEUS LI-RADS categories showed no significant differences in RFS after resection.

Serological indices and ultrasound variables in predicting the staging of hepatitis B liver fibrosis: A comparative study based on random forest algorithm and traditional methods.

Objective: To compare the diagnostic efficacy of serological indices and ultrasound (US) variables in hepatitis B virus (HBV) liver fibrosis staging using random forest algorithm (RFA) and traditional methods. Methods: The demographic and serological indices and US variables of patients with HBV liver fibrosis were retrospectively collected and divided into serology group, US group, and serology + US group according to the research content. RFA was used for training and validation. The diagnostic efficacy was compared to logistic regression analysis (LRA) and APRI and FIB-4 indices. Results: For the serology group, the diagnostic performance of RFA was significantly higher than that of APRI and FIB-4 indices. The diagnostic accuracy of RFA in the four classifications (S0S1/S2/S3/S4) of the hepatic fibrosis stage was 79.17%. The diagnostic accuracy for significant fibrosis (≥S2), advanced fibrosis (≥S3), and cirrhosis (S4) was 87.99%, 90.69%, and 92.40%, respectively. The area under the curve (AUC) values were 0.945, 0.959, and 0.951, respectively. For the US group, there was no significant difference in diagnostic performance between RFA and LRA. The diagnostic performance of RFA in the serology + US group was significantly better than that of LRA. The diagnostic accuracy of the four classifications (S0S1/S2/S3/S4) of the hepatic fibrosis stage was 77.21%. The diagnostic accuracy for significant fibrosis (≥S2), advanced fibrosis (≥S3), and cirrhosis (S4) was 87.50%, 90.93%, and 93.38%, respectively. The AUC values were 0.948, 0.959, and 0.962, respectively. Conclusion: RFA can significantly improve the diagnostic performance of HBV liver fibrosis staging. RFA based on serological indices has a good ability to predict liver fibrosis staging. RFA can help clinicians accurately judge liver fibrosis staging and reduce unnecessary biopsies.

Synthesis and antitumor evaluation of novel hybrids of phenylsulfonylfuroxan and epiandrosterone/dehydroepiandrosterone derivatives.

Thirteen novel furoxan-based nitric oxide (NO) releasing hybrids (14a-e, 15a-e, 17b-d) of 16,17-pyrazo-annulated steroidal derivatives were synthesized and evaluated against the MDA-MB-231, HCC1806, SKOV-3, DU145, and HUVEC cell lines for their in vitro anti-proliferative activity. Most of the compounds displayed potent anti-proliferative effects. Among them, 17c exhibited the best activity with IC50 values of 20-1.4nM against four cell lines (MDA-MB-231, SKOV-3, DU145, and HUVEC), and 1.03µM against a tamoxifen resistant breast cancer cell line (HCC1806). Furthermore, five compounds (14a, 15a, 17b-d) were selected to screen for VEGF inhibitory activity. Compounds 15a, 17b,c showed obviously better activity than 2-Methoxyestradiol (2-ME) on reducing levels of VEGF secreted by MDA-MB-231 cell line. In a Capillary-like Tube Formation Assay, compounds 17b,c exhibited a significant suppression of the tubule formation in the concentration of 1.75nM and 58nM, respectively. The preliminary SAR showed that steroidal scaffolds with a linker in 3-position were favorable moieties to evidently increase the bioactivities of these hybrids. Overall, these results implied that 17c merited to be further investigated as a promising anti-cancer candidate.