NLR、PLR、LMR及PNI对晚期肝细胞癌靶向联合免疫治疗临床疗效及预后的预测价值OA北大核心

Objective:To investigate the value of neutrophil-lymphocyte ratio(NLR),platelet-lymphocyte ratio(PLR),lymphocyte-monocyte ratio(LMR)and prognostic nutrition index(PNI)in predicting the curative effect and prognosis of patients with advanced hepatocellular carcinoma(HCC)treated with combined therapy of immune checkpoint inhibitors(ICI)and antiangiogenic drugs.Methods:The general clinical data,NLR,PLR,LMR and PNI of patients before treatment,clinical efficacy and prognosis of 85 advanced HCC patients admitted and treated with combined therapy of ICI and antiangiogenic drugs between January 2020 and December 2023 in the First Affiliated Hospital of Dali University were collected.The optimal cut-off values of NLR、PLR、LMR and PNI were obtained using receiver operating characteristic(ROC)curve,and used to divide the patients into the high and low groups.Kaplan-Meier method was used for survival analysis;Cox proportional risk model was used for the univariate and multivariate analysis of the effects of these values on the patient's OS.Results:The therapeutic effective rates in the low NLR,low PLR,high LMR and high PNI groups were respectively higher than those of the high NLR,high PLR,low LMR and low PNI groups(all P<0.05).The patient's OS rates in the low NLR,low PLR groups were respectively significantly higher than those in the high NLR,high PLR groups(all P<0.05).The patient's OS rates in the high LMR,high PNI groups were respectively significantly higher than those in the low LMR,low PUI groups(all P<0.05).NLR≥1.94,male and HBV infection were independent risk factors for the prognosis of advanced HCC patients(all P<0.05).Conclusion:NLR≥1.94,male,HBV positive are risk factors influencing the efficacy and prognosis of patients.NLR≥1.94 has certain clinical value in evaluating the efficacy and prognosis of combined immunotherapy and targeted therapy for advanced HCC patients.