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Volume 640 Issue 8060, 24 April 2025

Spatial awareness

The complex ecosystem of cells and blood vessels that make up the tumour microenvironment exerts a strong influence over how tumours form, grow and respond to treatment. Aspects of the microenvironment, such as the distribution and location of immune cells, can be used to predict disease outcomes, and in this week’s issue, Cheng Sun and colleagues capitalize on this to create an image-based scoring methodology that can predict whether liver cancer is likely to recur after surgery. The researchers focused on the most common form of liver cancer, hepatocellular carcinoma, which has a high recurrence rate. They found that the spatial distribution of immune cells called natural killer cells, and five genes expressed by those cells, was linked to improved outcomes after surgery. This allowed the team to develop the tumour immune microenvironment spatial (TIMES) score, a spatial-profiling system using artificial intelligence that can predict recurrence of liver cancer based on where in the microenvironment the genes are expressed.

Cover image: Cheng Sun.

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