基于常规参数的简化得分的预后值在肝细胞癌患者治疗全身疗法:一个回顾性队列研究

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Leonardo G Da Fonseca¹, Thamires Haick Martins da Silveira¹, Victor Junji Yamamoto¹

¹Clinical Oncology, Sao Paulo Cancer Institute (ICESP), University of São Paulo School of Medicine, Sao Paulo, SP, Brazil.

Journal of gastrointestinal oncology

|November 12, 2025

概括

使用alpha-fetoprotein,albumin-bilirubin等级和中性粒细胞与淋巴细胞比率的新简化的预后得分可以预测治疗索拉费尼布或免疫治疗的晚期肝细胞癌 (HCC) 患者的生存结果.

科学领域:

肝胆瘤学肝胆瘤学
临床生物标志物临床生物标志物
系统性癌症治疗系统性癌症治疗

背景情况:

晚期肝细胞癌 (HCC) 治疗已经从氨酸激酶抑制剂 (sorafenib) 转向免疫检查点抑制剂 (IO).
目前的预后工具缺乏简单性和客观性来分层HCC患者的结果.
不同HCC治疗方式中常见实验室参数的综合实用性尚不清楚.

研究的目的:

评估常见可用的生物标志物的预后价值在先进的HCC.
开发一种简化的预后得分,适用于用索拉费尼布 (SOR) 或免疫检查点抑制剂 (IO) 治疗的患者.

主要方法:

在先进的HCC患者接受一线全身治疗 (SOR或IO) 的回顾性队列研究.
评估了生存和基线生物标志物之间的关联:α-fetoprotein (AFP),albumin-bilirubin (ALBI) 等级和中性粒细胞与淋巴细胞比率 (NLR).
根据不良因素制定了预后得分:AFP≥200 ng/mL,ALBI等级2-3,NLR≥3.

主要成果:

三种常规生物标志物 (AFP,ALBI,NLR) 独立地与HCC患者的整体存活率 (OS) 更差相关.
简化的预后得分有效地分层了索拉费尼布队列中的OS (P<0.001).
该得分还显示了免疫治疗队列的预后价值 (HR 2.2;P=0.04).

结论:

使用三个常规实验室参数进行简化的预后得分,对接受索拉费尼布或免疫治疗的高级HCC患者的存活率进行分层.
这种工具有助于为HCC提供个性化的临床咨询和风险调整的临床试验设计.
建议在更大,更多样化的群体中进一步验证.

关键词:

肝脏新生瘤的发生.肝硬化是肝硬化的一种疾病.肝细胞癌 (HCC) 是一种肝细胞癌.预后预后预后球队的成绩球队的成绩球队的成绩

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