Middle East Journal of Cancer

Impact of MRI Findings and Clinical Parameters on Predicting Tumor-Infiltrating Lymphocytes in Hepatocellular Carcinoma Patients

Articles in Press

Document Type : Original Article(s)

Authors

Yaser Arafat 1
Amrallah Mohammed 1
Ahmad Barakat Waley 1
Basma Soliman K 2
Mohamed S. Bayomi 3
Amira Hanna 4
Basant EL-Shafaay 4
Marwa M. EL- Mosely 5
Doaa Mandour 4

1 Medical Oncology Department, Faculty of Medicine, Zagazig University, Egypt

2 RadiodiagnosisDepartment, Faculty of Medicine, Zagazig University, Egyptt

3 General Surgery Department, Faculty of Medicine, Zagazig University, Egypt

4 Clinical Oncology and Nuclear Medicine Department, Faculty of Medicine, Zagazig University, Egypt

5 Pathology Department, Faculty of Medicine, Zagazig University, Egypt

10.30476/mejc.2026.110435.2398
Abstract
Background: The preoperative identification of tumor-infiltrating lymphocyte (TIL) status in hepatocellular carcinoma (HCC) is clinically important, but the ability of magnetic resonance imaging (MRI) features combined with clinical parameters to predict TIL levels remains unclear. The present study aimed to investigate whether MRI features and clinical parameters can predict TIL levels in patients with HCC undergoing surgical resection.
Method: A retrospective study of 156 HCC patients categorized TILs into; group 0 (low TIL, 0%–10%), group 1 (intermediate TIL, 11%–59%), and group 2 (high TIL, ≥60%). Continuous and categorical variables were compared using appropriate tests. Logistic regression identified predictors of TILs.
Results: Of 131 included patients, 37.9% were included in group 0, 12.2% in group 1, and 50.4% in group 2. Group 0 was significantly associated with ≥60 years of age, grade III, microvascular invasion, alpha-fetoprotein (AFP) >400 ng/ml, satellite nodules, unclear tumor boundaries, irregular shapes, non-smooth margins, absence of tumor capsule, and larger size (P < 0.05 for all). AFP level (odds ratio (OR) 0.19; 95% confidence interval (CI) 0.08-0.75, P = 0.03), tumor shape (OR 6.31; 95% CI 2.44-40.31, P = 0.01), margin (OR 0.13; 95% CI 0.05-0.6, P = 0.03), and tumor size on MRI (OR 0.99; 95% CI 1.06-1.49, P = 0.04) were independent predictors of TIL levels.
Conclusion: Preoperative MRI features, including tumor morphology, margin characteristics, and tumor size, together with serum AFP levels, showed a significant value in predicting TIL density in HCC patients undergoing surgical resection. These findings highlight MRI as a non-invasive tool for preoperative assessment and risk stratification.

Keywords

Hepatocellularcarcinoma
Tumor-infiltrating lymphocytes
Magnetic resonance imaging
Subjects

Please cite this article as: Arafat Y, Mohammed A, BarakatWaley A, K Soliman B, S. Bayomi M, Hanna A, et al. Impact of MRI Findings and Clinical Parameters on Predicting Tumor-Infiltrating Lymphocytes in Hepatocellular Carcinoma Patients. Middle East J Cancer. 2026: in press. doi: 10.30476/mejc.2026.110435.2398.

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Middle East Journal of Cancer

Articles in Press, Accepted Manuscript
Available Online from 01 April 2027

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