The Value Of Systemic Immune Inflammatory Index Combined With Prognostic Nutritional Index To Evaluate The Prognosis Of Patients With Hepatitis B-related Hepatocellular Carcinoma After TACE

Objective: To evaluate the predictive value of Systemic immune inflammatory index(SII)and prognostic nutrition index(PNI)in patients with hepatitis B-associated hepatocellular carcinoma TACE surgery,and find new evaluation indicators from the aspects of immune inflammation and nutritional status of patients throughout the body for clinical decision-making.Methods: A retrospective analysis was performed on 158 patients with hepatitis B-associated hepatocellular carcinoma who received TACE treatment in the Affiliated Hospital of Traditional Chinese Medicine of Southwest Medical University from June 2011 to June 2017.The patient’s basic clinical data,tumor markers,blood routine within one week before surgery,coagulation indexes,liver function,Barcelona clinical liver cancer stage,basic lesions,MVI,whether there is extrahepatic metastasis,etc.were collected.The ROC curve was plotted to determine the optimal cut-off values of SII and PNI,and the correlation between SII and PNI and clinicopathological features was evaluated.The Cox proportional hazards regression model was used to analyze the risk factors and independent risk factors for postoperative TACE in patients with hepatitis B-related HCC.The patient survival curve was plotted using the K-M method and tested with logrank.Results: As of the follow-up endpoint time of June 30,2022,a total of 5of 158 patients survived and 153 died,with a median survival time of 26 months.The 158 patients were divided into two groups according to the critical values of SII and PNI calculated by the ROC curve,namely SII ≥ 417.89(82cases),SII < 417.89(76 cases),PNI ≥ 44.03(90 cases)and PNI < 44.03(68cases).Univariate analysis showed that SII level,PNI level,sex,AFP,maximum diameter of lesions,BCLC stage,MVI and number of lesions were risk factors affecting the survival time of HCC patients after TACE.Cox multivariate survival analysis showed that SII level,PNI level,and AFP value were independent risk factors affecting the survival time of patients.The patient’s survival was analyzed by the K-M method.The results showed that the median survival time of the high SII-low PNI group,high SII-high PNI group,low SII-low PNI group,and low SII-high PNI group was 14 months,21 months,30 mont,hs and 45 months,respectively,and the survival curves between the four groups were statistically significant(P<0.001).Conclusion: 1.SII levels can stratify patients for risk,and there are significant differences in clinical information and the overall survival of patients between strata.2.PNI levels can stratify patients for risk,and there are significant differences in clinical information the and overall survival of patients between strata.3.SII level and PNI level are independent prognostic factors for OS after TACE in patients with hepatitis B-related HCC,and SII combined with PNI can stratify patients for risk in a finer way.