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Published on: April 12, 2024
Development of a Novel Inflammation-Based Index for Hepatocellular Carcinoma
Stephen Lam Chan1, Lin-Lee Wong2,3, Kwan-Chee Allen Chan4
1Laboratory of Translational Oncology, Department of Clinical Oncology, Sir YK Pao Centre for Cancer, Institute of Digestive Disease, The Chinese University of Hong Kong, Hong Kong, China.
A new Integrated Liver Inflammatory Score (ILIS) was developed to predict outcomes in hepatocellular carcinoma (HCC) patients. This novel index, using five blood markers, outperforms existing scores and correlates with circulating inflammatory markers.
Area of Science:
- Hepatology
- Oncology
- Biomarker Development
Background:
- Hepatocellular carcinoma (HCC) poses a significant global health challenge.
- Accurate prognostic tools are crucial for managing HCC patients.
- Existing inflammatory indices may lack specificity or optimal performance in HCC.
Purpose of the Study:
- To construct and validate a novel HCC-specific inflammatory index.
- To compare the prognostic performance of the Integrated Liver Inflammatory Score (ILIS) against established inflammatory indices in HCC.
- To investigate the association between ILIS and systemic/intratumoral inflammatory markers.
Main Methods:
- Development of a novel index (ILIS) using a training set from the Hong Kong cohort (n=627).
- Validation of ILIS in independent validation sets from Hong Kong (n=688) and Newcastle (n=574) cohorts.
- Comparative analysis of ILIS against four existing inflammatory indices (neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, prognostic nutrition index, systemic immune-inflammation index).
- Exploratory analysis of correlations between ILIS, circulating cytokines, and intratumoral gene expression.
Main Results:
- The ILIS was formulated using albumin, bilirubin, alkaline phosphatase, neutrophil count, and alpha-fetoprotein levels.
- ILIS effectively categorized patients into three risk groups across validation cohorts.
- ILIS demonstrated superior prognostic performance for overall survival compared to other indices and remained an independent prognosticator.
- ILIS correlated with circulating inflammatory cytokines (e.g., IL-8) but not with intratumoral inflammatory gene expression.
Conclusions:
- The Integrated Liver Inflammatory Score (ILIS) is a validated, HCC-specific prognostic index.
- ILIS is constructed from five easily accessible blood parameters and validated in diverse populations.
- ILIS shows correlation with circulating inflammatory markers, suggesting a link to systemic inflammation in HCC.
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