Chinese scientists and their Singaporean collaborators have developed a scoring system to predict the risk of recurrence for hepatocellular carcinoma, a serious form of liver cancer, achieving an accuracy of 82.2 percent, according to the international academic journal Nature.

The Tumor Immune Microenvironment Spatial system is the first tool in the world to integrate spatial immune information that can be used to predict HCC recurrence.

Led by Sun Cheng, a professor at the University of Science and Technology of China, the team of scientists published its findings in Nature on Thursday.

HCC is a type of liver cancer that originates in the main liver cell, known as hepatocytes. It is the most common form of primary liver cancer and typically occurs in individuals with chronic liver diseases such as cirrhosis and hepatitis B or C infections.

"HCC ranks as the third-leading cause of cancer-related deaths globally, with a high recurrence rate of up to 70 percent post-surgery," said Sun, adding that accurately predicting HCC recurrence has been a challenge.

Sun's team and collaborators found that the spatial distribution of immune cells plays a crucial role in determining clinical outcomes, revolutionizing tumor micro-environment assessment.

The team analyzed the spatial distribution of immune cells in HCC tissues from 61 patients and identified five key biomarkers crucial for predicting HCC recurrence risk.

By combining these biomarkers and using advanced machine learning algorithms, the TIMES system scores significantly outperformed existing risk stratification tools such as the TNM and BCLC systems, which are commonly used tools for staging and classifying HCC.

Validation studies involving 231 patients from five multicentered cohorts demonstrated the robustness of the TIMES system, with an accuracy of 82.2 percent and a specificity of 85.7 percent.

Notably, the predictive power of these biomarkers stemmed from their spatial distributions within the tumor micro-environment, rather than their individual expression levels.

Further investigations into the biological significance of SPON2, one of the five key markers in the TIMES system, revealed its role in enhancing natural killer cells' activity and inhibiting tumor progression.

Experiments with SPON2-knockout mice showed promising results in reducing HCC recurrence risk, shedding light on potential therapeutic interventions.

To make the TIMES system accessible to the clinical community, the team has developed a user-friendly online platform where healthcare providers can upload standard pathology images or data to receive personalized HCC recurrence risk reports.

The core algorithms and models of the TIMES system are patented, and the team is actively seeking collaborations with industry partners to facilitate its widespread clinical application.

Michael T Lotze, a professor at the University of Pittsburgh in the United States, praised the study for its innovative approach.

"The study provides compelling evidence for the primacy of spatial immune contexture in prognosticating hepatocellular carcinoma," Lotze said in his review. "It establishes a methodological framework that could be broadly applicable across solid tumor malignancies, potentially guiding immunotherapeutic interventions through precise spatial immune profiling."

Immunotherapeutic interventions refer to treatments that harness the body's immune system to fight diseases, including cancer.