<p>Inflammation-Based Prognostic Scores in Patients with Hepatitis B Virus-Related Hepatocellular Carcinoma After Liver Transplantation</p>

Abstract

Background: Inflammation-based prognostic scores including systemic immuneinflammation index (SII), platelet to lymphocyte ratio (PLR) and neutrophil to lymphocyte ratio (NLR) have prognostic value in various cancers. We investigated the prognostic value of SII, PLR and NLR in patients who underwent liver transplantation (LT) for HBV-related hepatocellular carcinoma (HCC). Methods: We retrospectively analyzed the records of 189 patients who underwent LT for HBV-related HCC. The receiver operating characteristic (ROC) curve was used to determine the optimal SII, PLR and NLR cutoff value. Overall survival (OS) and recurrence-free survival (RFS) following LT were calculated. The Kaplan-Meier method and the Cox proportional hazards model were used to evaluate the prognostic value of SII, PLR and NLR. Results: The 1-, 3-, and 5-year OS rates were significantly lower in the high SII group (74.1%, 34.2%, and 32.3%, respectively) than in the low SII group (78.5%, 66.9%, and 59.9%, respectively; p = 0.000). The 1-, 3-, and 5-year RFS rates were, respectively, 75.9%, 59.7%, and 49.4% in the high SII group and 93.3%, 80.2%, and 73.7% in the low SII group (p = 0.000). Finally, OS curves were plotted by the Kaplan-Meier method and compared using the Log rank test. High PLR and NLR scores were also associated with poor OS (p = 0.000 and p = 0.003) and poor RFS (p = 0.000 and p = 0.000). The multivariate analysis demonstrated that AFP ≥400 ng/mL, high MELD score, largest tumor size ≥5cm, SII ≥449.61, NLR ≥5.29, and PLR ≥98.52 were independent prognostic factors for OS. Conclusion: High SII, PLR and NLR are significantly poor prognostic factors for overall survival and recurrence-free survival in patients with HBV-related hepatocellular carcinoma after liver transplantation.

Prognostic value of a nomogram based on peripheral blood immune parameters in unresectable hepatocellular carcinoma after intensity-modulated radiotherapy

“…SII, a novel prognostic biomarker, can comprehensively reflect the changes in inflammation and peripheral blood counts in the body. In early studies, it was found that increased preoperative SII may be an independent prognostic marker for HCC patients undergoing hepatectomy and liver transplantation and that OS prediction was better than PLR and NLR [21,22]. In addition, a meta-analysis revealed that high preoperative SII was associated with HCC vascular invasion and tumor diameter, which indirectly suggested poor prognosis [23].…”

LDH and GGT/ALT Ratio as Novel Prognostic Biomarkers in Hepatocellular Carcinoma Patients after Liver Transplantation

“…These results sometimes can only work when there is a definite recurrence of HCC, so we want to seek some indices which can predict the survival of HCC after LT easily. Recent studies have shown that tumor inflammatory microenvironments can contribute to the risk of proliferation, invasion, and migration of carcinoma [9], suggesting the role of preoperative peripheral blood inflammation markers, such as C-reactive protein levels [10], platelet-to-lymphocyte ratio [11], and neutrophil-to-lymphocyte ratio [12,13] in the postoperative period. In addition, liver inflammation indices such as gamma-glutamyl transferase (GGT), alanine aminotransferase (ALT), aspartate aminotransferase, and lactate dehydrogenase (LDH) levels have been associated with the risk of HCC recurrence after hepatectomy [14,15].…”

A preoperative model for predicting microvascular invasion and assisting in prognostic stratification in liver transplantation for HCC regarding empirical criteria

“…Inflammatory indices in patients with leukopenia and leukocytosis were excluded in the analysis given the likelihood of alterations from an acute infectious or inflammatory process rather than chronic cancer-related effects. In this study, the NLR was calculated by the ratio of the absolute count of neutrophils to lymphocytes, the PLR was calculated by the ratio of the count of platelets to lymphocytes, LMR was calculated by the ratio of the absolute count of lymphocytes to monocytes, ABR was calculated by the ratio of the absolute count of albumin to bilirubin [15] . Moreover, we examined preoperative abdominal imaging and pathology from the resected tumor with recurrence-free survival (RFS) and OS.…”