Predictive value of preoperative inflammatory indexes for postoperative early recurrence of hepatitis B-related hepatocellular carcinoma

Guo Wenpei; Li Yuan; Li Liangbo; Mu Jingjun; Wang Bo; Niu Zhiqiang; Ning Yijie; Liu Lixin

doi:10.3389/fonc.2023.1142168

Predictive value of preoperative inflammatory indexes for postoperative early recurrence of hepatitis B-related hepatocellular carcinoma

Front Oncol. 2023 Jul 13:13:1142168. doi: 10.3389/fonc.2023.1142168. eCollection 2023.

Authors

Guo Wenpei¹, Li Yuan², Li Liangbo³, Mu Jingjun⁴, Wang Bo⁵, Niu Zhiqiang⁶, Ning Yijie⁷, Liu Lixin^{1

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Affiliations

¹ Department of Gastroenterology and Hepatology, The First Hospital of Shanxi Medical University, Taiyuan, China.
² Department of Respiratory Medicine, Shanxi Province Cancer Hospital, Shanxi Hospital Affiliated to Cancer Hospital, Chinese Academy of Medical Sciences, Cancer Hospital Affiliated to Shanxi Medical University, Taiyuan, China.
³ Department of Stomatology, Chinese PLA General Hospital, Beijing, China.
⁴ Department of Urinary Surgery, Shanxi Province Cancer Hospital, Shanxi Hospital Affiliated to Cancer Hospital, Chinese Academy of Medical Sciences, Cancer Hospital Affiliated to Shanxi Medical University, Taiyuan, China.
⁵ Department of Pathology, Shanxi Province Cancer Hospital, The First Hospital of Shanxi Medical University, Taiyuan, China.
⁶ Department of Hepatobiliary Surgery, The First Hospital of Shanxi Medical University, Taiyuan, China.
⁷ Department of Neurosurgery, The First Hospital of Shanxi Medical University, Taiyuan, China.
⁸ Experimental Center of Science and Research, The First Hospital of Shanxi Medical University, Taiyuan, China.
⁹ Institute of Liver Diseases and Organ Transplantation, The First Hospital of Shanxi Medical University, Taiyuan, China.

Abstract

Objective: To investigate the predictive value of preoperative neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), systemic inflammation response index (SIRI), and systemic immune inflammation index (SII) for early recurrence after liver resection in patients with hepatitis B-related hepatocellular carcinoma.

Methods: A retrospective study was conducted on 162 patients who underwent hepatitis B-related hepatocellular carcinoma (HCC) resection between January 2013 and April 2016. The Youden index was utilized to calculate the optimal cut-off value. The Pearson Chi-square test was applied to analyze the relationship between inflammatory indexes and common clinical and pathological features. The Kaplan-Meier method and Log-Rank test were implemented to compare the recurrence-free survival rate within 2 years of the population. The Cox regression analysis was used to identify the risk factors for early postoperative recurrence.

Results: The best cut-off values of SIRI, PLR, NLR and SII were 0.785, 86.421, 2.231 and 353.64, respectively. Tumor diameter, degree of tumor differentiation, vascular invasion, SIRI>0.785, PLR>86.421, NLR>2.231 and SII>353.64 were risk factors for early recurrence. Combining the above seven risk factors to construct a joint index, the AUC of the joint prediction model was 0.804. The areas under the ROC curves of SIRI, PLR, NLR, and SII were 0.659, 0.725, 0.680, and 0.723, respectively. There was no significant difference in the predictive ability between the single inflammatory index models, but the predictive performance of the joint prediction model was significantly higher than that of the single inflammatory index models. The patients with lower SIRI, PLR, NLR, SII and joint index value had longer recurrence-free survival within 2 years.

Conclusion: The joint index CIP, constructed by combining preoperative SIRI, PLR, NLP and SII with pathological features, can better predict the early recurrence of HBV-related HCC patients after surgery, which is beneficial in identifying high-risk patients and assisting clinicians to make better clinical choices.

Keywords: hepatitis B virus; hepatocellular carcinoma; inflammatory indexes; predictive models; recurrence.