Sugama Yusuke, Miyanishi Koji, Osuga Takahiro, Tanaka Shingo, Hamaguchi Kota, Ito Ryo, Sakamoto Hiroki, Kubo Tomohiro, Ohnuma Hiroyuki, Murase Kazuyuki, Takada Kohich, Kobune Masayoshi, Kato Junji
Department of Medical Oncology Sapporo Medical University School of Medicine Sapporo Japan.
Department of Infection Control and Laboratory Medicine Sapporo Medical University School of Medicine Sapporo Japan.
JGH Open. 2021 Nov 19;5(12):1335-1343. doi: 10.1002/jgh3.12676. eCollection 2021 Dec.
Reliable predictors for hepatocellular carcinoma (HCC) are urgently needed. The psoas muscle index (PMI) is a simple and rapid method for evaluating muscle atrophy. Furthermore, the neutrophil/lymphocyte ratio (NLR) is a prognostic factor that is easy to calculate in everyday clinical practice. We aimed to investigate the value of the PMI and NLR as prognostic factors for patients receiving nonsurgical HCC therapy, hepatic arterial infusion chemotherapy (HAIC), transcatheter arterial chemoembolization (TACE), or molecular targeted drugs such as sorafenib (SOR) and lenvatinib (LEN).
We enrolled 87 patients with HCC who were treated with HAIC, TACE, SOR, or LEN. The primary endpoint was overall survival (OS) with variable PMI or NLR status. For Barcelona Clinic Liver Cancer (BCLC)-B patients, useful prognostic factors were examined by comparing the OS between stratified groups. Prognostic factors including PMI and NLR were evaluated by univariate and multivariate analysis.
Analysis of HAIC or TACE (HAIC/TACE) and SOR or LEN (SOR/LEN) patients showed significant differences in OS between low and high PMI. In patients treated with TACE, there was a significant difference in OS between low and high NLR. For BCLC-B and low PMI, the prognosis was significantly worse for SOR/LEN than for TACE, although there was no difference for high PMI, suggesting that PMI may be useful for treatment selection. In addition, the prognostic formula composed of PMI, NLR, and up-to-seven criteria developed in the present study may be useful.
PMI and NLR are considered to be independent prognostic factors for HCC.
肝细胞癌（HCC）急需可靠的预测指标。腰大肌指数（PMI）是评估肌肉萎缩的一种简单快速的方法。此外，中性粒细胞/淋巴细胞比值（NLR）是一种在日常临床实践中易于计算的预后因素。我们旨在研究PMI和NLR作为接受非手术HCC治疗、肝动脉灌注化疗（HAIC）、经动脉化疗栓塞（TACE）或索拉非尼（SOR）和仑伐替尼（LEN）等分子靶向药物治疗的患者的预后因素的价值。
我们纳入了87例接受HAIC、TACE、SOR或LEN治疗的HCC患者。主要终点是不同PMI或NLR状态下的总生存期（OS）。对于巴塞罗那临床肝癌（BCLC）-B期患者，通过比较分层组之间的OS来检查有用的预后因素。通过单因素和多因素分析评估包括PMI和NLR在内的预后因素。
对HAIC或TACE（HAIC/TACE）组和SOR或LEN（SOR/LEN）组患者的分析显示，低PMI和高PMI患者的OS存在显著差异。在接受TACE治疗的患者中，低NLR和高NLR患者的OS存在显著差异。对于BCLC-B期且PMI较低的患者，SOR/LEN组的预后明显比TACE组差，尽管高PMI患者无差异，这表明PMI可能有助于治疗选择。此外，本研究中由PMI、NLR和多达七个标准组成的预后公式可能有用。
PMI和NLR被认为是HCC的独立预后因素。
