Wei Shao-Ming, Zeng Zhen-Xin, Pan Rong-Jian, Wu Jia-Yi, Wu Jun-Yi, Luo Meng-Chao, Li Yi-Nan, Li Han, Liu De-Yi, Ou Xiang-Ye, Zhang Zhi-Bo, Zhou Jian-Yin, Li Bin, Zhuang Shao-Wu, Yan Mao-Lin
Shengli Clinical Medical College of Fujian Medical University, Department of Hepatobiliary Pancreatic Surgery, Fujian Provincial Hospital, Fuzhou University Affiliated Provincial Hospital, Fuzhou, Fujian Province, People's Republic of China.
Department of Hepatopancreatobiliary Surgery, First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian Province, People's Republic of China.
J Inflamm Res. 2025 Jun 10;18:7545-7557. doi: 10.2147/JIR.S520339. eCollection 2025.
PURPOSE: The combined systemic immune-inflammation index (SII) and prognostic nutritional index (PNI) (SII-PNI score) serves as a prognostic predictor in various malignancies. This study evaluates the prognostic value of the SII-PNI score in patients with unresectable hepatocellular carcinoma (uHCC) treated with transcatheter arterial chemoembolization combined with lenvatinib and PD-1 inhibitors (triple therapy). PATIENTS AND METHODS: This retrospective multicenter study included patients with uHCC treated with triple therapy from eight hospitals. The optimal cut-off values for SII and PNI were determined using X-tile. The SII-PNI score was categorized as follows: score of 0, low SII (≤cut-off value) and high PNI (>cut-off value); score of 1, either high SII-high PNI or low SII-low PNI; score of 2, high SII and low PNI. Survival curves were estimated and compared using the Kaplan-Meier method with the Log rank test. RESULTS: A total of 290 patients were included. The optimal cut-off values were 525.9 for SII and 44.0 for PNI. Patients were classified as SII-PNI score of 0 (n = 105), score of 1 (n = 124), and score of 2 (n = 61). Lower SII-PNI score was associated with better median overall survival (score of 0: not reached vs score of 1: 28.0 months vs score of 2: 19.7 months; < 0.001). Similarly, the median progression-free survival for SII-PNI scores of 0, 1, and 2 was 25.5, 16.6, and 12.9 months, respectively ( < 0.001). Lower SII-PNI score also indicated better objective response rate ( = 0.007) and disease control rate ( = 0.003). The SII-PNI score was identified as an independent predictor of overall survival and progression-free survival in multivariate COX regression analysis. CONCLUSION: The SII-PNI score is associated with survival and tumor response in patients with uHCC treated with triple therapy. This score aids in optimizing clinical decision-making for uHCC.
目的：联合系统免疫炎症指数（SII）和预后营养指数（PNI）（SII-PNI评分）可作为多种恶性肿瘤的预后预测指标。本研究评估SII-PNI评分在接受经动脉化疗栓塞联合乐伐替尼和PD-1抑制剂（三联疗法）治疗的不可切除肝细胞癌（uHCC）患者中的预后价值。 患者与方法：这项回顾性多中心研究纳入了来自八家医院接受三联疗法治疗的uHCC患者。使用X-tile确定SII和PNI的最佳临界值。SII-PNI评分分类如下：0分，低SII（≤临界值）和高PNI（>临界值）；1分，高SII-高PNI或低SII-低PNI；2分，高SII和低PNI。采用Kaplan-Meier法和Log rank检验估计并比较生存曲线。 结果：共纳入290例患者。SII的最佳临界值为525.9，PNI的最佳临界值为44.0。患者被分类为SII-PNI评分为0（n = 105）、1（n = 124）和2（n = 61）。较低的SII-PNI评分与较好的中位总生存期相关（0分：未达到，1分：28.0个月，2分：19.7个月；<0.001）。同样，SII-PNI评分为0、1和2的患者的中位无进展生存期分别为25.5、16.6和12.9个月（<0.001）。较低的SII-PNI评分也表明客观缓解率更高（=0.007）和疾病控制率更高（=0.003）。在多变量COX回归分析中，SII-PNI评分被确定为总生存期和无进展生存期的独立预测指标。 结论：SII-PNI评分与接受三联疗法治疗的uHCC患者的生存和肿瘤反应相关。该评分有助于优化uHCC的临床决策。
Transl Lung Cancer Res. 2025-5-30
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