The role of intratumoral necrosis subtypes on early recurrence risk after hepatectomy in hepatocellular carcinoma

To investigate the role of different intratumoral necrosis subtypes liquefactive necrosis (LN) and coagulation necrosis (CN) on early recurrence after surgical resection in patients with hepatocellular carcinoma (HCC), and to explore the underlying mechanisms using bioinformatics approaches. A total of 241 HCC patients were included in this study, of which 166 were clinical cases (27 CN and 28 LN) in hospital and other 75 (24 LN and 51 CN) were from The Cancer Genome Atlas Liver Hepatocellular Carcinoma (TCGA-LIHC) database. MRI imaging features (e.g., tumor size, capsule integrity) were compared among different HCC groups with LN, CN or no necrosis (NN) using Chi-square test. Cox proportional hazards regression models were applied to identify independent predictors of early recurrence in HCC and their Hazard Ratios (HRs). Bioinformatics methods were used to screen Differentially Expressed Genes (DEGs) between LN and CN groups. Imaging analysis revealed that LN was significantly higher than CN in irregularly shaped tumors (LN 71.43% vs. CN 29.63%, P = 0.002). The LN group ( P < 0.001, HR = 4.15) conferred a 2.00-fold higher recurrence risk compared with CN group ( P = 0.042, HR = 2.08). K-M analysis further confirmed the difference ( P = 0.039). Bioinformatics analysis suggests that keratin (KRT) family genes may be related to the LN group. The recurrence risk of LN group is higher than that of CN group. Based on bioinformatics, it is hypothesized that high expression of the KRT gene may be related to enhanced tumor cell proliferation and invasion. Not applicable.