Abstract 969P
Background
Alpha-fetoprotein (AFP) is widely used for HCC screening in at-risk populations, but its performance is suboptimal. Routine blood test panels provide insights on multiple cancer-related conditions and have shown to improve detection in other cancers. Hence, we explore the foundation for a new high-dimensional data approach taking multiple routine laboratory parameters and their intricate interactions into consideration with AI. In this study, a routine blood test signature for HCC derived from big clinical data is described
Methods
This is a population-based retrospective study. Patient records from 2000 to 2018 were retrieved from the Hong Kong Hospital Authority Data Collaboration Laboratory. CLD patients with and without HCC were identified based on ICD codes, antiviral drug history, virology test and radiology reports. Patients with decompensated CLD were excluded. Routine blood tests retrieved included CBC, LFT, RFT and clotting profile. Blood records within one month before the diagnosis of HCC and CLD patients were retrieved. Statistical analysis included descriptive statistics and Mann-Whitney U (MWU) test.
Results
The cohort yielded 223,862 patients including 31,149 patients with HCC (13.9%) and 192,713 without. Statistical test results showed a distinctive spectral signature for HCC patients compared to those without HCC. It is characterized by the concurrent presence of more significant liver function derangement (raised ALT, ALP, bilirubin, AST and decreased albumin), tendency for systemic inflammation (lower lymphocyte and RDW), tendency for bleeding (prolonged PT and APTT, low platelet) and suggestions of cachexia (lower albumin, creatinine and urea), all were statistically significant (P<0.05, MWU test)
Conclusions
This is the first study to describe a routine blood signature for HCC detection established by big clinical data. The spectral characteristics of HCC separated well from CLD controls. The novel spectrum provides solid clinical ground for the use of advanced machine learning to generate an interactive classification model to detect HCC. In a companion abstract, we describe the development of the proposed signature, which is shown to be superior to AFP in HCC screening.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The Hong Kong University of Science and Technology.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.
Resources from the same session
956P - Phase II study of adjuvant tislelizumab combined with interferon-α and active surveillance in hepatocellular carcinoma patients with microvascular invasion
Presenter: Yixiu Wang
Session: Poster session 18
957P - Interim report of Notable-HCC: A phase Ib study of neoadjuvant PD-1 with stereotactic body radiotherapy in patients with resectable hepatocellular carcinoma (HCC)
Presenter: Mingming Li
Session: Poster session 18
959P - Combination therapy of envafolimab and suvemcitug in patients with hepatocellular carcinoma (HCC): Results from a phase II clinical trial
Presenter: Lixia Ma
Session: Poster session 18
960P - Personalized circulating tumor DNA (ctDNA) monitoring for recurrence detection and treatment response assessment in hepatocellular carcinoma (HCC)
Presenter: Maen Abdelrahim
Session: Poster session 18
961P - Blood circulating Galectin-3 is a prognostic biomarker in hepatocellular carcinoma
Presenter: Shadi Chamseddine
Session: Poster session 18
962P - SBRT improves the efficacy of immuno-checkpoint inhibitors for hepatocellular carcinoma through the activation of IL-6/JAK1-STAT3/PD-L1 axis mediated by MBD3 degradation
Presenter: Weiwei Yan
Session: Poster session 18
963P - Discovery and validation of cfDNA methylation, AFP and ctDNA mutation for the early detection of hepatocellular carcinoma: A multicenter prospective study (ASCEND-Hep)
Presenter: Mingxin Pan
Session: Poster session 18
966P - Potential role of neuropilin-1 in the prognosis, development and risk of invasion in hepatocellular carcinoma patients
Presenter: Tania Payo-Serafín
Session: Poster session 18