Prognostic Nutritional Index and Systemic Immune-Inflammation Index Predict the Prognosis of Patients with HCC

Abstract

Introduction Systemic nutrition and inflammation are the critical factors in cancer initiation, evolution, and progression. This study aimed to evaluate the prognostic value of the prognostic nutritional index (PNI) and systemic immune-inflammation index (SII) in hepatocellular carcinoma (HCC) patients who underwent liver resection. Methods A total of 202 HCC patients met the criteria and were included in the study. The receiver operating characteristic (ROC) curve was used to calculate the optimal PNI and SII cutoff values. The relationship between PNI/SII and clinicopathologic parameters was analyzed. The effect of PNI and SII on recurrence-free survival (RFS) and overall survival (OS) was investigated by Kaplan-Meier curves and Cox proportional hazards models. Results The areas under the ROC curve for PNI and SII were 0.64 and 0.58. The ideal preoperative PNI and SII cutoff values were 50.25 and 461.5, respectively. Multivariate Cox regression analysis identified that the PNI (P = 0.001) and tumor diameter (P = 0.018) were significant prognostic markers for RFS, and that the PNI (P = 0.049), SII (P = 0.039) and tumor diameter (P = 0.001) were significant prognostic markers for OS. The median RFS in the PNI-low and PNI-high groups was 13.5 months and 23 months (P = 0.001), and that in the SII-low and SII-high groups was 18 months and 15 months (P = 0.03), respectively. The median OS in the PNI-low and PNI-high groups was 24 months and 39 months (P = 0.001), and that in the SII-low and SII-high groups was 36 months and 22 months (P = 0.002), respectively. Conclusion Interestingly, we found that PNI and SII could be important prognostic parameters for HCC patients who under hepatectomy.

Preoperative systemic immune-inflammation index predicts prognosis and guides clinical treatment in patients with non-small cell lung cancer

“…Recently, a new inflammatory index, the systemic immune-inflammation index (SII), defined as neutrophil × platelet/lymphocyte, integrates three inflammatory cells and has been shown to be promising [12]. The prognostic value of SII has been confirmed in various cancers, including NSCLC [13], small cell lung cancer [14], esophageal squamous cell carcinoma (SqCC) [15], breast cancer [16] and hepatocellular cancer [17]. However, to the best of our knowledge, the association of SII with tumor progression and the implication of SII in postoperative adjuvant chemotherapy in operable NSCLC patients remain largely unknown.…”

Prognostic nutritional index predicts acute kidney injury and mortality of patients in the coronary care unit

“…The prognostic nutritional index (PNI), which is calculated from the serum albumin concentration and total lymphocyte count in the peripheral blood, is an index that reflects chronic inflammation, immune system and nutritional status and indicates prognostic significance in different patients ( 8 ). PNI had been described as a simple and objective indicator of adverse outcomes not only in chronic conditions, such as hepatocellular carcinoma ( 9 ), chronic heart failure ( 10 ) and different cancer types ( 11 ), but also in acute illnesses, including acute coronary syndrome ( 12 ), acute heart failure ( 13 ) and stroke ( 14 ). Furthermore, a previous study demonstrated an association between PNI and AKI in patients with normal serum creatinine levels who underwent coronary artery bypass grafting ( 15 ).…”

<p>Prognostic Significance of Preoperative Gamma-Glutamyltransferase to Alkaline Phosphatase Ratio in Hepatocellular Carcinoma Patients with Curative Liver Resection: A Retrospective Cohort Study</p>

“…[5][6][7][8] Systemic immuneinflammation indices 9 (neutrophil-to-lymphocyte ratio (NLR), 10 platelet-to-lymphocyte ratio (PLR) 11 ), gammaglutamyltransferase to albumin ratio index (GARI) 12 and gamma-glutamyltransferase to platelet ratio index (GPRI) 13 have been proven in many studies to effectively identify high-risk HCC patients with a poor prognosis, and CA125 and prognostic nutritional index (PNI) were associated with tumor recurrence after liver resection. 14,15 These models are constructed through blood biochemical indicators that are relatively easy to obtain in the clinic and are related to the physiological functions of the liver. Importantly, the prognosis of HCC patients depends not only on tumor burden (tumor number, size, portal vein thrombosis and extrahepatic spread) but also on underlying liver function.…”