临床显著性门脉高压（CSPH）已被确认为在接受根治性治疗的肝细胞癌（HCC）患者中的重要预后因素。本研究旨在评估PH估计作为免疫治疗下HCC患者的预后因素。包括在2016年至2021年期间在我们的三级医疗中心接受第一或后续行治疗的HCC患者（n = 50）。使用成熟的非侵入性PH评估预处理CT数据的PH得分进行CSPH诊断（截止值≥4）。在单变量和多变量分析中评估PH对总生存期（OS）和无进展生存期（PFS）的影响。根据PH评分，有26名患者（52.0％）被认为患有CSPH。治疗开始后，患有CSPH的患者的中位OS（4.1 vs 33.3个月，p <0.001）和中位PFS（2.7 vs 5.3个月，p = 0.02）明显受损。在多变量Cox回归中，当调整成熟的风险因素时，CSPH仍与生存率显着相关（HR 2.9，p = 0.015）。使用常规CT数据的非侵入性评估CSPH为HCC和免疫治疗患者提供了独立的预后因素。因此，它可能作为一种额外的影像标志物，用于检测生存不良的高风险患者，并可能用于治疗决策的制定。

Clinically significant portal hypertension (CSPH) has been identified as an important prognostic factor in patients with hepatocellular carcinoma (HCC) undergoing curative treatment. This study aimed to assess PH estimates as prognostic factors in patients with HCC treated with immunotherapy.All patients with HCC treated with an immunotherapeutic agent in first or subsequent lines at our tertiary care center between 2016 and 2021 were included (n = 50). CSPH was diagnosed using the established PH score for non-invasive PH estimation in pre-treatment CT data (cut-off ≥ 4). Influence of PH on overall survival (OS) and progression-free survival (PFS) was assessed in uni- and multivariable analyses.Based on the PH score, 26 patients (52.0%) were considered to have CSPH. After treatment initiation, patients with CSPH had a significantly impaired median OS (4.1 vs 33.3 months, p < 0.001) and a significantly impaired median PFS (2.7 vs 5.3 months, p = 0.02). In multivariable Cox regression, CSPH remained significantly associated with survival (HR 2.9, p = 0.015) when adjusted for established risk factors.Non-invasive assessment of CSPH using routine CT data yielded an independent prognostic factor in patients with HCC and immunotherapy. Therefore, it might function as an additional imaging biomarker to detect high-risk patients with poor survival and possibly for treatment decision making.© 2023. The Author(s).