State Key Laboratory in Oncology of South China, Hong Kong, China.
Department of Clinical Oncology, Sir YK Pao Center for Cancer, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, China.
Liver Int. 2017 Feb;37(2):280-289. doi: 10.1111/liv.13218. Epub 2016 Aug 29.
BACKGROUNDS & AIMS: A number of circulating inflammatory factors are implicated in the pathogenesis and prognostication of hepatocellular carcinoma (HCC). We aim to evaluate the prognostication of multiple serum inflammatory factors simultaneously and develop an objective inflammatory score for HCC.
A prospective cohort of 555 patients with HCC with paired serum samples was accrued from 2009 to 2012. The blood levels of conventional inflammatory markers, namely C-reactive protein (CRP), albumin, neutrophils, lymphocytes and platelet, were determined, and 41 other exploratory markers were measured by a multiplex assay. The prognostication and interaction of markers were determined by univariate and multivarite analyses.
The cohort was randomly divided into training cohort (n=139) and validation cohort (n=416). There were no differences in baseline characteristics between the two cohorts. In the training cohort, independent prognostic factors for overall survival included CRP (hazard ratio [HR] 1.107; P=.003), albumin (HR 0.953; P=.032) and interleukin-8 (HR=5.816; P<.001). We have modified the existing inflammation-based index (IBI) by adding serum interleukin-8 level. The modified IBI could stratify patients into four groups with distinct overall survival (P<.001). The results were also validated in the validation cohort. When compared with IBI and other conventional inflammatory markers, the modified IBI had better prognostic performance with higher c-index and homogeneity likelihood ratio chi-square.
Among the conventional and exploratory circulating inflammatory markers, higher CRP, lower albumin and higher interleukin-8 were independent prognosticators. By combining these factors, a simple and accurate inflammatory index could be constructed.
许多循环炎症因子与肝细胞癌（HCC）的发病机制和预后有关。我们旨在同时评估多种血清炎症因子的预后，并为 HCC 开发一种客观的炎症评分。
从 2009 年到 2012 年，我们招募了 555 名 HCC 伴配对血清样本的前瞻性队列患者。测定了常规炎症标志物（即 C 反应蛋白（CRP）、白蛋白、中性粒细胞、淋巴细胞和血小板）的血液水平，并通过多重分析测定了 41 种其他探索性标志物。通过单变量和多变量分析确定标志物的预后和相互作用。
该队列被随机分为训练队列（n=139）和验证队列（n=416）。两组之间的基线特征没有差异。在训练队列中，总生存期的独立预后因素包括 CRP（风险比[HR]1.107；P=.003）、白蛋白（HR 0.953；P=.032）和白细胞介素-8（HR=5.816；P<.001）。我们通过添加血清白细胞介素-8 水平对现有的炎症指数（IBI）进行了修正。改良的 IBI 可以将患者分为四个具有明显总生存期的组（P<.001）。该结果在验证队列中也得到了验证。与 IBI 和其他常规炎症标志物相比，改良 IBI 具有更好的预后性能，具有更高的 c 指数和同质性似然比卡方。
在常规和探索性循环炎症标志物中，较高的 CRP、较低的白蛋白和较高的白细胞介素-8是独立的预后因素。通过结合这些因素，可以构建一个简单而准确的炎症指数。
