Sun Shasha, Li Wendong, Guo Xiaodi, Chen Jinglong
Department of Oncology, Capital Medical University Beijing Ditan Hospital, Chaoyang District, Beijing, People's Republic of China.
Hum Vaccin Immunother. 2024 Dec 31;20(1):2394268. doi: 10.1080/21645515.2024.2394268. Epub 2024 Dec 12.
This study aimed to investigate the role of the neutrophil-to-lymphocyte ratio (NLR) and prognostic nutritional index (PNI) in unresectable hepatocellular carcinoma (HCC) patients treated with tyrosine kinase inhibitors (TKIs) and immune checkpoint inhibitors (ICIs). The optical cutoff values of the NLR and PNI were determined via time-dependent receiver operating characteristic curve analysis. The associations between overall survival (OS) and various potential risk factors were analyzed. Forty-nine HCC patients were enrolled in this retrospective study. The optimal pretreatment NLR and PNI cutoff values were 2.4 and 41, respectively. The median follow-up was 8 (range 3-36) months. The median OS in the high NLR subgroup was lower than that in the low NLR subgroup (7 vs. 9 months, < .05). However, the high PNI group had better OS than the low PNI group did (12 vs. 7 months, < .05). Univariate analysis revealed that tumor distribution ( = .003), PNI < 41 ( = .013), and NLR ≥ 2.4 ( = .010) were associated with unfavorable OS in HCC patients. The multivariate analysis revealed that the PNI (HR = 0.353, 95% CI 0.150-0.831; = .017) and tumor distribution (HR = 0.336, 95% CI 0.137-0.826; = .017) were independent indicators of poor prognosis. A pretreatment NLR ≥ 2.4 and PNI < 41 are related to poor survival in unresectable HCC patients receiving TKI and ICI treatment. Moreover, a lower PNI is an independent indicator of poor prognosis when ICIs are combined with TKIs.
本研究旨在探讨中性粒细胞与淋巴细胞比值（NLR）和预后营养指数（PNI）在接受酪氨酸激酶抑制剂（TKIs）和免疫检查点抑制剂（ICIs）治疗的不可切除肝细胞癌（HCC）患者中的作用。通过时间依赖性受试者工作特征曲线分析确定NLR和PNI的最佳截断值。分析总生存期（OS）与各种潜在危险因素之间的关联。49例HCC患者纳入本回顾性研究。预处理时NLR和PNI的最佳截断值分别为2.4和41。中位随访时间为8（3 - 36）个月。高NLR亚组的中位OS低于低NLR亚组（7个月对9个月，P < 0.05）。然而，高PNI组的OS优于低PNI组（12个月对7个月，P < 0.05）。单因素分析显示，肿瘤分布（P = 0.003）、PNI < 41（P = 0.013）和NLR≥2.4（P = 0.010）与HCC患者的不良OS相关。多因素分析显示，PNI（HR = 0.353，95%CI 0.150 - 0.831；P = 0.017）和肿瘤分布（HR = 0.336，95%CI 0.137 - 0.826；P = 0.017）是预后不良的独立指标。预处理时NLR≥2.4和PNI < 41与接受TKI和ICI治疗的不可切除HCC患者的不良生存相关。此外，当ICI与TKI联合使用时，较低的PNI是预后不良的独立指标。
