Prognostic value of preoperative systemic immune-inflammation index/albumin for patients with hepatocellular carcinoma undergoing curative resection  

作　　者：Kun-Lin Chen Yi-Wen Qiu Ming Yang Tao Wang Yi Yang Hai-Zhou Qiu Ting Sun Wen-Tao Wang 

机构地区：[1]Department of Liver Surgery,West China Hospital of Sichuan University,Chengdu 610041,Sichuan Province,China

出　　处：《World Journal of Gastroenterology》2024年第48期5130-5151,共22页世界胃肠病学杂志（英文）

基　　金：Supported by The National Natural Science Foundation of China,No.81770566 and No.82000599;The NHC Key Laboratory of Echinococcosis Prevention and Control,No.2021WZK1004;The Health Commission of the Tibet Autonomous Region,No.311220432.

摘　　要：BACKGROUND Hepatocellular carcinoma(HCC)is a major factor for cancer-associated mortality globally.Although the systemic immune-inflammation index(SII)and albumin(ALB)show individual prognostic value for various cancers,their combined significance(SII/ALB)in HCC patients undergoing curative hepatectomy is still unknown.It is hypothesized that a higher SII/ALB ratio correlates with poorer outcomes with regard to overall survival(OS)and recurrence-free survival(RFS).AIM To investigate the effect of preoperative SII/ALB in predicting the prognosis of HCC patients undergoing hepatectomy.METHODS Patients who received curative surgery for HCC at a single institution between 2014 and 2019 were retrospectively analyzed.Cox proportional hazards models and Kaplan-Meier curves were utilized to estimate OS and RFS.A nomogram was created using prognostic factors determined by the least absolute shrinkage and selection operator method and analyzed using multivariate Cox regression.This nomogram was assessed internally through the calibration plots,receiver operating characteristic(ROC)analysis,decision curve analysis(DCA)and the concordance index(C-index).RESULTS This study enrolled 1653 HCC patients.Multivariate analyses demonstrated that SII/ALB independently predicted OS[hazard ratio(HR)=1.22,95%CI:1.03-1.46,P=0.025]and RFS(HR=1.19,95%CI:1.03-1.38,P=0.022).Age,alpha-fetoprotein,hepatitis B surface antigen,albumin-bilirubin grade,tumor diameter,portal vein tumor thrombus,tumor number,and SII/ALB were incorporated into the nomogram to predict OS.The nomogram had a C-index of 0.73(95%CI:0.71-0.76)and 0.71(95%CI:0.67-0.74)for the training and validation cohorts,respectively.The area under the ROC curve,DCA and calibration curves demonstrated high accuracy and clinical benefits.CONCLUSION The SII/ALB may independently predict outcomes in HCC patients who receive curative surgical treatment.In addition,the nomogram can be used in HCC treatment decision-making.

关 键 词：Hepatocellular carcinoma Inflammation Systemic immune-inflammation index/albumin Liver resection Prognosis 

分 类 号：R735.9[医药卫生—肿瘤]