Prognostic Value of Inflammation-Immunity-Nutrition Score and Inflammatory Burden Index for Hepatocellular Carcinoma Patients After Hepatectomy

Rui Song; Hanghang Ni; Juntao Huang; Chenglei Yang; Shangdong Qin; Huaning Wei; Jiefu Luo; Yuxiang Huang; Bangde Xiang

doi:10.2147/JIR.S386407

Prognostic Value of Inflammation-Immunity-Nutrition Score and Inflammatory Burden Index for Hepatocellular Carcinoma Patients After Hepatectomy

J Inflamm Res. 2022 Nov 28:15:6463-6479. doi: 10.2147/JIR.S386407. eCollection 2022.

Authors

Rui Song^#^{1

2}, Hanghang Ni^#¹, Juntao Huang^#¹, Chenglei Yang¹, Shangdong Qin^{1

3}, Huaning Wei¹, Jiefu Luo¹, Yuxiang Huang¹, Bangde Xiang^{1

2

3}

Affiliations

¹ Department of Hepatobiliary Surgery, Guangxi Medical University Cancer Hospital, Nanning, People's Republic of China.
² Key Laboratory of Early Prevention and Treatment for Regional High-Frequency Tumors, Ministry of Education, Nanning, People's Republic of China.
³ Guangxi Liver Cancer Diagnosis and Treatment Engineering and Technology Research Center, Nanning, People's Republic of China.

^# Contributed equally.

Abstract

Purpose: The study aimed to investigate the ability of inflammation-immunity-nutrition score (IINS) and inflammatory burden index (IBI), individually or in combination, to predict prognosis of hepatocellular carcinoma (HCC) patients after hepatectomy.

Methods: A total of 701 patients who underwent HCC resection at Guangxi Medical University Cancer Hospital were enrolled in the study. An IINS ranging from 0 to 3 was defined based on preoperative C-reactive protein (CRP), lymphocyte count, and serum albumin level, while an IBI was based on CRP and neutrophil-to-lymphocyte ratio. The prognostic value of IINS and IBI was assessed using univariate and multivariate Cox regression and Kaplan-Meier survival curves. The concordance index and calibration curve were used for internal validation of models. Decision curve analysis, net reclassification index and integrated discrimination improvement were used to compare the predictive performance of the models with traditional staging systems.

Results: IINS and IBI were able to predict poor prognosis in HCC patients after hepatectomy, and a nomogram based on the IINS predicted survival at 1, 3, and 5 years better than other models or traditional staging systems.

Conclusion: IINS may be accurate predictors of survival in HCC patients after hepatectomy, with potentially greater prognostic value than conventional markers.

Keywords: hepatectomy; hepatocellular carcinoma; inflammation-immunity-nutrition score; inflammatory burden index; prognosis.

Grants and funding

This work was supported by grants from the National Natural Science Foundation of China (81960450), the High-Level Innovation Team and Outstanding Scholar Program in Guangxi Colleges and Universities, the “139” Projects for Training of High-level Medical Science Talents from Guangxi, the Key Research and Development Project of Guangxi (AB20297009, AA18221001, AB18050020), the Key Laboratory of Early Prevention and Treatment for Regional High-Frequency Tumors of the Ministry of Education, the Guangxi Independent Research Project (GKE2019-ZZ07, GKE-ZZ202005, GKE-ZZ202111), and the Development and Application of Medical and Health Appropriate Technology in Guangxi (S2019039).