Comparison of the prognostic value of inflammation-based scores in early recurrent hepatocellular carcinoma after hepatectomy
Comparison of the prognostic value of inflammation-based scores in early recurrent hepatocellular carcinoma after hepatectomy
复制标题
炎症评分对肝切除术后早期复发性肝细胞癌预后价值的比较
DOI：
10.1111/liv.14281
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发表时间：
2019-11-28
影响因子：
6.7
通讯作者：
Yuan, Yunfei
中科院分区：
文献类型：
--
作者：
Wang, Chenwei;He, Wei;Yuan, Yunfei
背景与目的基于炎症的预后评分，如格拉斯哥预后评分（GPS）、改良格拉斯哥预后评分（mGPS）、预后指数（PI）、预后营养指数（PNI）、中性粒细胞/淋巴细胞比率（NLR）、血小板/淋巴细胞比率（PLR）、淋巴细胞/单核细胞比率（LMR）和全身免疫炎症指数（SII），与肝细胞癌（HCC）患者的生存率相关，但与复发HCC的关系尚不清楚。本研究旨在比较基于炎症的预后评分对早期复发性HCC（ErHCC，肝切除术后2年内）患者复发后生存率（PRS）的预后价值。方法回顾性分析580例ErHCC患者的临床资料。通过考克斯回归分析独立基线和时间依赖变量与PRS之间的相关性。通过时间依赖性受试者工作特征（ROC）和Harrell一致性指数（C-index）分析评估基于炎症的预后评分的预测准确性。结果GPS、mGPS、PI、PNI、NLR、PLR、LMR和SII均与ErHCC患者的PRS相关，而SII（P <0.001）仍是PRS的独立预测因子（危险比：1.92，95%可信区间：1.33-2.79）。SII评分的C指数（0.65）和ROC曲线下面积均显示SII评分对ErHCC患者PRS的预测优于其他基于炎症的预后评分（上级）。结论SII评分是预测ErHCC术后患者预后的一个有用指标，其预测能力上级于其他炎症评分。
Background & Aims Inflammation-based prognostic scores, such as the Glasgow Prognostic Score (GPS), modified Glasgow Prognostic Score (mGPS), Prognostic Index (PI), Prognostic Nutritional Index (PNI), neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR), lymphocyte to monocyte ratio (LMR) and systemic immune-inflammation index (SII), are correlated with the survival of hepatocellular carcinoma (HCC) patients, while remain unclear for recurrent HCC. This study aimed to compare the prognostic value of inflammation-based prognostic scores for post-recurrence survival (PRS) in patients with early recurrent HCC (ErHCC, within 2 years after hepatectomy). Methods A total of 580 patients with ErHCC were enrolled retrospectively. The association between the independent baseline and the time-dependent variables and PRS was evaluated by cox regression. The prediction accuracy of the inflammation-based prognostic scores was assessed by time-dependent receiver operating characteristic (ROC) and Harrell's concordance index (C-index) analyses. Results The GPS, mGPS, PI, PNI, NLR, PLR, LMR and SII were all related to the PRS of ErHCC patients, while only the SII (P < .001) remained an independent predictor for PRS in multivariate analysis (hazard ratio: 1.92, 95% confidence interval: 1.33-2.79). Both the C-index of the SII (0.65) and the areas under the ROC curves showed that the SII score was superior to the other inflammation-based prognostic scores for predicting the PRS of ErHCC patients. Conclusions The SII is a useful prognostic indicator for PRS in patients with ErHCC after hepatectomy and is superior to the other inflammation-based prognostic scores in terms of prognostic ability.