Blood Biomarkers Predict Survival Outcomes in Patients with Hepatitis B Virus-Induced Hepatocellular Carcinoma Treated with PD-1 Inhibitors

Abstract

Purpose: To investigate the prognostic value of blood markers in patients with hepatitis B virus (HBV)-induced hepatocellular carcinoma (HCC) treated with PD-1 inhibitors. Patients and Methods. We retrospectively collected and analyzed the clinicopathological data of 110 HBV-induced HCC patients treated with PD-1 inhibitors. Progression-free survival (PFS) and overall survival (OS) were scrutinized using Kaplan-Meier analysis and the log-rank test, and all potential risk factors were analyzed with univariate and multivariate Cox regression analyses.

Results: The mean OS and PFS were 6.5 and 5.5 months, respectively. According to Kaplan-Meier survival curves, elevated systemic immune-inflammation index (SII), platelet-to-lymphocyte ratio (PLR), and neutrophil-to-lymphocyte ratio (NLR) correlated with decreased OS and PFS (all P < 0.05), and low lymphocyte-to-monocyte ratio (LMR) correlated with decreased PFS and OS (all P < 0.05). Per multivariate Cox regression analyses, SII, PLR, and portal vein tumor thrombus (PVTT) correlated independently with PFS (all P < 0.05), whereas SII, PLR, NLR, and portal vein tumor thrombus (PVTT) correlated with OS (all P < 0.05).

Conclusion: SII, PLR, and PVTT predicted OS and PFS in HCC patients who received PD-1 inhibitors and, therefore, could be useful predictors for risk stratification and individualized therapeutic decision-making for patients with HBV-induced HCC treated with PD-1 inhibitors.

Figure 1

Receiver operating characteristic curves were generated to evaluate the discriminatory ability of the systemic immune-inflammation index, platelet-to-lymphocyte ratio, neutrophil-to-lymphocyte ratio, and lymphocyte-to-monocyte ratio. SII: systemic immune-inflammation index; PLR: platelet-to-lymphocyte ratio; NLR: neutrophil-to-lymphocyte ratio; LMR: lymphocyte-to-monocyte ratio.

Figure 2

The Kaplan–Meier survival curves indicated that elevated SII, PLR, and NLR were associated with decreased PFS (a–c). Conversely, decreased LMR was associated with decreased PFS (d).

Figure 3

The Kaplan–Meier survival curves indicated that elevated SII, PLR, and NLR were associated with decreased OS (a–c). Conversely, decreased LMR was associated with decreased OS (d).