Evidence map›Paper›PMID 40089963›Full record

ArticleHepatology international2025

Explainable attention-enhanced heuristic paradigm for multi-view prognostic risk score development in hepatocellular carcinoma.

Anran Liu, Jiang Zhang, Tong Li, Danyang Zheng, Yihong Ling, Lianghe Lu, Yuanpeng Zhang, Jing Cai

Abstract read
In one paragraph

Article in Hepatology international, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Review
4 · The record

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PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Anran LiuDepartment of Health Technology and Informatics, Hong Kong Polytechnic University, 11 Yuk Choi Road, Hong Kong SAR, China.
Jiang ZhangDepartment of Health Technology and Informatics, Hong Kong Polytechnic University, 11 Yuk Choi Road, Hong Kong SAR, China.
Tong LiDivision of Computational & Data Sciences, Washington University in St. Louis, One Brookings Drive, St. Louis, MO, 63130, USA.
Danyang ZhengDepartment of Anesthesiology, First Affiliated Hospital of Sun Yat-sen University, No. 58 Zhongshan Road 2, Guangzhou, 510060, Guangdong, China.
Yihong LingDepartment of Pathology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, 651 Dongfeng East Road, Guangzhou, 510060, Guangdong, China.
Lianghe LuDepartment of Liver Surgery, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, 651 Dongfeng East Road, Guangzhou, 510060, Guangdong, China.
Yuanpeng ZhangDepartment of Health Technology and Informatics, Hong Kong Polytechnic University, 11 Yuk Choi Road, Hong Kong SAR, China.
Jing CaiDepartment of Health Technology and Informatics, Hong Kong Polytechnic University, 11 Yuk Choi Road, Hong Kong SAR, China. jing.cai@polyu.edu.hk.

Funding

General Research Fund GRF 15104323RGC Theme-based Research Scheme T45-401/22-N
6 · The paper itself

Abstract

purposeExisting prognostic staging systems depend on expensive manual extraction by pathologists, potentially overlooking latent patterns critical for prognosis, or use black-box deep learning models, limiting clinical acceptance. This study introduces a novel deep learning-assisted paradigm that complements existing approaches by generating interpretable, multi-view risk scores to stratify prognostic risk in hepatocellular carcinoma (HCC) patients.

methods510 HCC patients were enrolled in an internal dataset (SYSUCC) as training and validation cohorts to develop the Hybrid Deep Score (HDS). The Attention Activator (ATAT) was designed to heuristically identify tissues with high prognostic risk, and a multi-view risk-scoring system based on ATAT established HDS from microscopic to macroscopic levels. HDS was also validated on an external testing cohort (TCGA-LIHC) with 341 HCC patients. We assessed prognostic significance using Cox regression and the concordance index (c-index).

resultsThe ATAT first heuristically identified regions where necrosis, lymphocytes, and tumor tissues converge, particularly focusing on their junctions in high-risk patients. From this, this study developed three independent risk factors: microscopic morphological, co-localization, and deep global indicators, which were concatenated and then input into a neural network to generate the final HDS for each patient. The HDS demonstrated competitive results with hazard ratios (HR) (HR 3.24, 95% confidence interval (CI) 1.91-5.43 in SYSUCC; HR 2.34, 95% CI 1.58-3.47 in TCGA-LIHC) and c-index values (0.751 in SYSUCC; 0.729 in TCGA-LIHC) for Disease-Free Survival (DFS). Furthermore, integrating HDS into existing clinical staging systems allows for more refined stratification, which enables the identification of potential high-risk patients within low-risk groups.

conclusionThis novel paradigm, from identifying high-risk tissues to constructing prognostic risk scores, offers fresh insights into HCC research. Additionally, the integration of HDS complements the existing clinical staging system by facilitating more detailed stratification in DFS and Overall Survival (OS).

Indexed as

Carcinoma, HepatocellularDeep LearningLiver NeoplasmsAgedFemaleHeuristicsHumansMaleMiddle AgedNeoplasm StagingPrognosisRisk AssessmentRisk FactorsArtificial intelligenceDeep learning-assisted diagnosisDisease-free survivalHepatocellular carcinomaInterpretabilityLymphocytesNecrosisOverall survivalPrognostic risk scoringWhole slide images

Identifiers

PMID40089963
PMCPMC12287236

What Socratic holds

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LicenceCC BY
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.