Correlation Of Peripheral Hematological Markers With Response To PD-1 Inhibitor Therapy In Hepatocellular Carcinoma

OBJECTIVE: To explore the correlation of peripheral hematological markers with the efficacy of hepatocellular carcinoma treated with programmed death receptor-1inhibitors(PD-1),and to find indicators with predictive value for curative effect.Methods: This study is a single-center retrospective study.The clinical characteristics and baseline hematological indicators before starting treatment of patients with hepatocellular carcinoma who received PD-1 inhibitor therapy in Tongji Hospital Affiliated to Tongji Medical College of Huazhong University of Science and Technology from March 2019 to December 2021 were collected.The optimal cut-off values of neutrophil-to-lymphocyte ratio(NLR),platelet-to-lymphocyte ratio(PLR),prognostic nutritional index(PNI),and lymphocyte-to-monocyte ratio(LMR)were obtained by receiver operating characteristic curve.Chi-square test or Fisher exact probability method was used to analyze the correlation between clinical characteristics and hematological indicators of patients and the objective response rate and disease control rate.Multivariate logistic regression analysis was performed to explore the factors affecting the efficacy of patients.For survival analysis,Kaplan-Meier survival curves were drawn,and the log-rank test was used to compare the progression-free survival(PFS)between different groups.Multivariate Cox regression analysis was used to explore independent influencing factors of patients’ prognosis.Results: A total of 112 patients with hepatocellular carcinoma were included in this study.The upper limit of normal value(225 U/L)was used as the critical value for lactate dehydrogenase.Univariate analysis showed that albumin-bilirubin score,alpha-fetoprotein,LDH,NLR,PLR and other indicators were correlated with the disease control rate.Multivariate analysis showed that LDH was an independent factor affecting the disease control rate(OR=0.262,95% CI:0.087-0.788,P=0.017).Univariate analysis of PFS showed that Child-Pugh grade,whether receiving local treatment,alpha-fetoprotein,LDH,NLR and other indicators were related to patients’ PFS.Multivariate analysis showed that LDH(HR=1.956,95% CI:1.093-3.502,P=0.024)and whether receiving local therapy(HR=0.416,95% CI:0.236-0.735,P=0.003)were independent influencing factors for PFS.Conclusion: Baseline LDH may have predictive value for treatment response in patients with hepatocellular carcinoma receiving PD-1 inhibitor therapy.