Liu Jianwei, Fang Kunpeng, Pei Shangfei, Gao Ya, Liu Liu, Tang Ming, Pan Xiaorong, Sun Minmin, Zhang Chengjing
Department of Hepatic Surgery II, Third Affiliated Hospital of Naval Medical University (Eastern Hepatobiliary Surgery Hospital), Shanghai, 200438, China.
Department of Special Treatment, Third Affiliated Hospital of Naval Medical University (Eastern Hepatobiliary Surgery Hospital), Shanghai, 200438, China.
BMC Cancer. 2025 Aug 2;25(1):1258. doi: 10.1186/s12885-025-14672-1.
To explore the relationship between the prognostic nutritional index (PNI) and the anti-tumor efficacy and prognosis of patients with advanced hepatocellular carcinoma (HCC) who received first-line therapy.
A total of 234 patients with advanced HCC were included in this study, all of whom received first-line therapy. The clinical and pathological data of patients were collected. Patients were divided into high PNI group and low PNI group according to the median value of PNI. Kaplan-Meier method was used to describe the curves of overall survival (OS) and progression-free survival (PFS), and the multivariate Cox analyses were performed to identify the independent risk factors for OS and PFS.
The median PNI of all patients was 46.2, and all patients were divided into low PNI group (n = 117) and high PNI group (n = 117). Multivariate Cox analysis showed that PNI (hazard ratio (HR): 0.584, 95 confidence interval (CI): 0.426-0.802; HR: 0.630, 95%CI: 0.482-0.825) was a prognostic factor of OS and PFS, and the prognosis of patients with high PNI was better than that of patients with low PNI. Subgroup analysis showed the similar results for patients receiving lenvatinib or atezolizumab plus bevacizumab (T + A). The overall response rate (ORR) of patients with high PNI was higher than that of patients with low PNI (P = 0.005). There was no statistical difference in the incidence of adverse reactions between the two groups.
High PNI is a prognostic factor affecting OS and PFS for patients with advanced HCC who received first-line therapy. Patients with high PNI have higher ORR and better prognosis. There was no significant difference in the incidence of adverse reactions among patients with high or low PNI.
探讨预后营养指数（PNI）与接受一线治疗的晚期肝细胞癌（HCC）患者的抗肿瘤疗效及预后之间的关系。
本研究共纳入234例晚期HCC患者，所有患者均接受一线治疗。收集患者的临床和病理资料。根据PNI的中位数将患者分为高PNI组和低PNI组。采用Kaplan-Meier法描述总生存期（OS）和无进展生存期（PFS）曲线，并进行多因素Cox分析以确定OS和PFS的独立危险因素。
所有患者的PNI中位数为46.2，所有患者被分为低PNI组（n = 117）和高PNI组（n = 117）。多因素Cox分析显示，PNI（风险比（HR）：0.584，95%置信区间（CI）：0.426 - 0.802；HR：0.630，95%CI：0.482 - 0.825）是OS和PFS的预后因素，高PNI患者的预后优于低PNI患者。亚组分析显示，接受乐伐替尼或阿替利珠单抗联合贝伐单抗（T+A）治疗的患者结果相似。高PNI患者的总缓解率（ORR）高于低PNI患者（P = 0.005）。两组不良反应发生率无统计学差异。
高PNI是接受一线治疗的晚期HCC患者OS和PFS的预后因素。高PNI患者具有更高的ORR和更好的预后。高PNI或低PNI患者的不良反应发生率无显著差异。
