Tao Zhou, Jiongze Fang, Jing Huang, Xi Yu, Yuying Shan, Shengdong Wu, Shuqi Mao, Caide Lu
{"title":"基于临床数据库的hbv相关HCC肝切除术后炎症标志物的预后价值","authors":"Tao Zhou, Jiongze Fang, Jing Huang, Xi Yu, Yuying Shan, Shengdong Wu, Shuqi Mao, Caide Lu","doi":"10.1080/08941939.2025.2475020","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>Hepatitis B virus (HBV) remains an important risk factor for hepatocellular carcinoma (HCC), and inflammation plays an essential role in tumor development. This study aimed to investigate the impact of inflammatory markers in the postoperative outcomes of patients with HBV-related HCC, providing valuable prognostic indicators after hepatectomy.</p><p><strong>Methods: </strong>We retrospectively analyzed 222 patients with HBV-related HCC after surgical resection. The ROC curve was used to calculate biomarker cutoff values. The Kaplan-Meier method was used to estimate overall survival (OS) and recurrence-free survival (RFS), and univariate and multivariate analyses were used to identify the prognostic factors.</p><p><strong>Results: </strong>The Kaplan-Meier analysis revealed that patients with high albumin-bilirubin (ALBI) score, aspartate aminotransferase to platelet ratio index (APRI), and monocyte to lymphocyte ratio (MLR) had worse OS, while those with high ALBI score and MLR had shorter RFS. Multivariate Cox regression analysis identified alpha-fetoprotein >400 ng/mL (hazard ratio [HR]: 2.447, 95% confidence interval [CI]: 1.273-4.706, <i>p</i> = 0.007), alanine aminotransferase (HR: 0.377, 95% CI: 0.171-0.834, <i>p</i> = 0.016), platelet to lymphocyte ratio (HR: 0.385, 95% CI: 0.196-0.755, <i>p</i> = 0.006), systemic inflammatory response index (HR: 1.844, 95% CI: 1.049-3.239, <i>p</i> = 0.033), ALBI score (HR: 1.808, 95% CI: 1.020-3.203, <i>p</i> = 0.043), APRI score (HR: 3.193, 95% CI: 1.662-6.137, <i>p</i> < 0.001), tumor diameter (HR: 1.083, 95% CI: 1.012-1.160, <i>p</i> = 0.022), and portal vein tumor thrombosis (PVTT) (HR: 6.083, 95% CI: 2.774-13.338, <i>p</i> < 0.0001) as independent predictors for OS. MLR (HR: 2.285, 95% CI: 1.290-4.048, <i>p</i> = 0.005) and PVTT (HR: 2.672, 95% CI: 1.280-5.579, <i>p</i> = 0.009) were confirmed as significant prognostic markers of RFS in patients with HBV-related HCC.</p><p><strong>Conclusions: </strong>ALBI score, APRI, and MLR are effective prognostic predictors in patients with HBV-related HCC after curative resection. Close monitoring and adjuvant therapies should be considered for high-risk patients.</p>","PeriodicalId":16200,"journal":{"name":"Journal of Investigative Surgery","volume":"38 1","pages":"2475020"},"PeriodicalIF":2.1000,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Prognostic Value of Inflammatory Markers in HBV-Related HCC After Hepatectomy Based on a Clinical Database.\",\"authors\":\"Tao Zhou, Jiongze Fang, Jing Huang, Xi Yu, Yuying Shan, Shengdong Wu, Shuqi Mao, Caide Lu\",\"doi\":\"10.1080/08941939.2025.2475020\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>Hepatitis B virus (HBV) remains an important risk factor for hepatocellular carcinoma (HCC), and inflammation plays an essential role in tumor development. This study aimed to investigate the impact of inflammatory markers in the postoperative outcomes of patients with HBV-related HCC, providing valuable prognostic indicators after hepatectomy.</p><p><strong>Methods: </strong>We retrospectively analyzed 222 patients with HBV-related HCC after surgical resection. The ROC curve was used to calculate biomarker cutoff values. The Kaplan-Meier method was used to estimate overall survival (OS) and recurrence-free survival (RFS), and univariate and multivariate analyses were used to identify the prognostic factors.</p><p><strong>Results: </strong>The Kaplan-Meier analysis revealed that patients with high albumin-bilirubin (ALBI) score, aspartate aminotransferase to platelet ratio index (APRI), and monocyte to lymphocyte ratio (MLR) had worse OS, while those with high ALBI score and MLR had shorter RFS. Multivariate Cox regression analysis identified alpha-fetoprotein >400 ng/mL (hazard ratio [HR]: 2.447, 95% confidence interval [CI]: 1.273-4.706, <i>p</i> = 0.007), alanine aminotransferase (HR: 0.377, 95% CI: 0.171-0.834, <i>p</i> = 0.016), platelet to lymphocyte ratio (HR: 0.385, 95% CI: 0.196-0.755, <i>p</i> = 0.006), systemic inflammatory response index (HR: 1.844, 95% CI: 1.049-3.239, <i>p</i> = 0.033), ALBI score (HR: 1.808, 95% CI: 1.020-3.203, <i>p</i> = 0.043), APRI score (HR: 3.193, 95% CI: 1.662-6.137, <i>p</i> < 0.001), tumor diameter (HR: 1.083, 95% CI: 1.012-1.160, <i>p</i> = 0.022), and portal vein tumor thrombosis (PVTT) (HR: 6.083, 95% CI: 2.774-13.338, <i>p</i> < 0.0001) as independent predictors for OS. MLR (HR: 2.285, 95% CI: 1.290-4.048, <i>p</i> = 0.005) and PVTT (HR: 2.672, 95% CI: 1.280-5.579, <i>p</i> = 0.009) were confirmed as significant prognostic markers of RFS in patients with HBV-related HCC.</p><p><strong>Conclusions: </strong>ALBI score, APRI, and MLR are effective prognostic predictors in patients with HBV-related HCC after curative resection. Close monitoring and adjuvant therapies should be considered for high-risk patients.</p>\",\"PeriodicalId\":16200,\"journal\":{\"name\":\"Journal of Investigative Surgery\",\"volume\":\"38 1\",\"pages\":\"2475020\"},\"PeriodicalIF\":2.1000,\"publicationDate\":\"2025-12-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Investigative Surgery\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1080/08941939.2025.2475020\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/4/11 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q2\",\"JCRName\":\"SURGERY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Investigative Surgery","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1080/08941939.2025.2475020","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/4/11 0:00:00","PubModel":"Epub","JCR":"Q2","JCRName":"SURGERY","Score":null,"Total":0}
引用次数: 0
摘要
目的：乙型肝炎病毒（HBV）仍然是肝细胞癌（HCC）的重要危险因素，炎症在肿瘤发展中起着至关重要的作用。本研究旨在探讨炎症标志物对hbv相关性HCC患者术后预后的影响，为肝切除术后预后提供有价值的指标。方法：回顾性分析222例乙肝相关肝细胞癌手术切除患者。ROC曲线用于计算生物标志物的截止值。采用Kaplan-Meier法估计总生存期（OS）和无复发生存期（RFS），并采用单因素和多因素分析确定预后因素。结果：Kaplan-Meier分析显示，白蛋白胆红素（ALBI）评分、天冬氨酸转氨酶与血小板比值指数（APRI）、单核细胞与淋巴细胞比值（MLR）高的患者OS较差，而ALBI评分和MLR高的患者RFS较短。多因素Cox回归分析确定甲胎蛋白>400 ng/mL（风险比[HR]: 2.447, 95%可信区间[CI]: 1.274 ~ 4.706, p = 0.007）、丙氨酸转氨酶（HR: 0.377, 95% CI: 0.171 ~ 0.834, p = 0.016）、血小板与淋巴细胞比值（HR: 0.385, 95% CI: 0.196 ~ 0.755, p = 0.006）、全身炎症反应指数（HR: 1.844, 95% CI: 1.049 ~ 3.239, p = 0.033）、ALBI评分（HR: 1.808, 95% CI: 1.020 ~ 3.203, p = 0.043）、APRI评分（HR: 3.193, 95% CI: 0.043）。1.662 ~ 6.137, p = 0.022)、门静脉肿瘤血栓形成（PVTT） （HR: 6.083, 95% CI: 2.774 ~ 13.338, p = 0.005）和PVTT （HR: 2.672, 95% CI: 1.280 ~ 5.579, p = 0.009）是hbv相关HCC患者RFS的重要预后指标。结论：ALBI评分、APRI和MLR是hbv相关HCC患者治愈性切除术后的有效预后预测指标。高危患者应考虑密切监测和辅助治疗。
Prognostic Value of Inflammatory Markers in HBV-Related HCC After Hepatectomy Based on a Clinical Database.
Objective: Hepatitis B virus (HBV) remains an important risk factor for hepatocellular carcinoma (HCC), and inflammation plays an essential role in tumor development. This study aimed to investigate the impact of inflammatory markers in the postoperative outcomes of patients with HBV-related HCC, providing valuable prognostic indicators after hepatectomy.
Methods: We retrospectively analyzed 222 patients with HBV-related HCC after surgical resection. The ROC curve was used to calculate biomarker cutoff values. The Kaplan-Meier method was used to estimate overall survival (OS) and recurrence-free survival (RFS), and univariate and multivariate analyses were used to identify the prognostic factors.
Results: The Kaplan-Meier analysis revealed that patients with high albumin-bilirubin (ALBI) score, aspartate aminotransferase to platelet ratio index (APRI), and monocyte to lymphocyte ratio (MLR) had worse OS, while those with high ALBI score and MLR had shorter RFS. Multivariate Cox regression analysis identified alpha-fetoprotein >400 ng/mL (hazard ratio [HR]: 2.447, 95% confidence interval [CI]: 1.273-4.706, p = 0.007), alanine aminotransferase (HR: 0.377, 95% CI: 0.171-0.834, p = 0.016), platelet to lymphocyte ratio (HR: 0.385, 95% CI: 0.196-0.755, p = 0.006), systemic inflammatory response index (HR: 1.844, 95% CI: 1.049-3.239, p = 0.033), ALBI score (HR: 1.808, 95% CI: 1.020-3.203, p = 0.043), APRI score (HR: 3.193, 95% CI: 1.662-6.137, p < 0.001), tumor diameter (HR: 1.083, 95% CI: 1.012-1.160, p = 0.022), and portal vein tumor thrombosis (PVTT) (HR: 6.083, 95% CI: 2.774-13.338, p < 0.0001) as independent predictors for OS. MLR (HR: 2.285, 95% CI: 1.290-4.048, p = 0.005) and PVTT (HR: 2.672, 95% CI: 1.280-5.579, p = 0.009) were confirmed as significant prognostic markers of RFS in patients with HBV-related HCC.
Conclusions: ALBI score, APRI, and MLR are effective prognostic predictors in patients with HBV-related HCC after curative resection. Close monitoring and adjuvant therapies should be considered for high-risk patients.
期刊介绍：
Journal of Investigative Surgery publishes peer-reviewed scientific articles for the advancement of surgery, to the ultimate benefit of patient care and rehabilitation. It is the only journal that encompasses the individual and collaborative efforts of scientists in human and veterinary medicine, dentistry, basic and applied sciences, engineering, and law and ethics. The journal is dedicated to the publication of outstanding articles of interest to the surgical research community.
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