Risaliti Matteo, De Peppo Valerio, Bartolini Ilenia, Tirloni Luca, Scarinci Andrea, Terrenato Irene, Grazi Gian Luca
Hepato-Pancreato-Biliary Surgery, Azienda Ospedaliero-Universitaria Careggi, Department of Clinical and Experimental Medicine, University of Florence, 50134 Florence, Italy.
Hepato-Pancreato-Biliary Surgery, IRCCS, Regina Elena National Cancer Institute, 00128 Rome, Italy.
J Clin Med. 2025 Aug 11;14(16):5665. doi: 10.3390/jcm14165665.
Tumor-associated inflammation plays a crucial role in supporting tumorigenesis and the progression of oncological diseases. This study aimed to evaluate whether systemic inflammatory indices are associated with overall survival (OS) in patients with hepatocellular carcinoma (HCC) undergoing surgery. : A retrospective cohort study was conducted on consecutive patients with HCC who underwent hepatic resection. Data were prospectively collected and retrospectively reviewed. The 5-year OS rate was used as the primary endpoint to stratify the values of inflammatory indices, including the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), lymphocyte-to-monocyte ratio (LMR), aspartate aminotransferase-to-neutrophil ratio index (ANRI), fibrinogen-to-albumin ratio (Fib-Alb), the systemic immune-inflammation index (SII), prognostic nutritional index (PNI), and aspartate aminotransferase-to-platelet ratio index (APRI), through receiver operating characteristic (ROC) curve analysis. The optimal albumin-bilirubin (ALBI) and platelet-ALBI (PALBI) cut-off points from the literature were also applied. : Patients included in the study were 153. The 1-, 3-, and 5-year OS rates were 81.7%, 65.2%, and 40.7%, respectively. Univariate Cox proportional hazards analysis showed that, in addition to several patient- and tumor-related characteristics and postoperative complications, elevated values of PLR, ANRI, Fib-Alb, SII, APRI, ALBI, and PALBI, as well as low PNI, were significantly associated with poorer overall survival (OS). Among these, only APRI and PNI emerged as independent prognostic factors in the multivariate analysis. : PNI and APRI could serve as valuable inflammatory indices for predicting OS, helping to identify HCC patients who might benefit from hepatic resection. However, further prospective studies with larger cohorts are needed to validate the prognostic role of PNI and APRI.
肿瘤相关炎症在支持肿瘤发生和肿瘤疾病进展中起着关键作用。本研究旨在评估全身炎症指标是否与接受手术的肝细胞癌（HCC）患者的总生存期（OS）相关。：对连续接受肝切除的HCC患者进行了一项回顾性队列研究。数据前瞻性收集并回顾性分析。采用5年总生存率作为主要终点，通过受试者工作特征（ROC）曲线分析对炎症指标值进行分层，包括中性粒细胞与淋巴细胞比值（NLR）、血小板与淋巴细胞比值（PLR）、淋巴细胞与单核细胞比值（LMR）、天冬氨酸转氨酶与中性粒细胞比值指数（ANRI）、纤维蛋白原与白蛋白比值（Fib-Alb）、全身免疫炎症指数（SII）、预后营养指数（PNI）和天冬氨酸转氨酶与血小板比值指数（APRI）。还应用了文献中最佳的白蛋白-胆红素（ALBI）和血小板-ALBI（PALBI）切点。：纳入研究的患者有153例。1年、3年和5年总生存率分别为81.7%、65.2%和40.7%。单因素Cox比例风险分析显示，除了一些患者和肿瘤相关特征及术后并发症外，PLR、ANRI、Fib-Alb、SII、APRI、ALBI和PALBI值升高以及PNI降低与较差的总生存期（OS）显著相关。其中，多因素分析中只有APRI和PNI成为独立的预后因素。：PNI和APRI可作为预测OS的有价值的炎症指标，有助于识别可能从肝切除中获益的HCC患者。然而，需要进一步开展更大样本量的前瞻性研究来验证PNI和APRI的预后作用。
