Abstract
Background: There are currently no recognised biomarkers that identify predictive groups of benefit in patients with hepatocellular carcinoma receiving immune-combined targeted therapy, for which we explored the value of peripheral blood markers as markers of their prognosis. Methods: Patients who underwent anti-PD-1 combination targeted therapy for hepatocellular carcinoma from 1 January 2019 to 31 December 2021 at the First Affiliated Hospital of Chongqing Medical University were retrospectively analysed. The data collected were analysed by R software. Results: A total of 41 cases were included in our study. The optimal threshold values of peripheral blood markers were obtained by plotting ROC curves and grouping patients. Survival analysis of the grouped patients showed statistically significant differences in survival between the different groups for Platelet-lymphocyte ratio (PLR, P = 0.0022), Monocyte-lymphocyte ratio (MLR, P = 0.042), Fibrinogen-Lymphocyte Ratio (FLR, P = 0.0009), Prognostic nutritional index (PIN, P = 0.0005), and Fibrinogen-albumin ratio (FAR, P = 0.0144). An ANOVA was performed on the basic conditions of the patients between the different groups, except for the statistically significant difference in BCLC stage (P = 0.0128) between the high MLR and low MLR groups, there was no statistically significant difference in age, gender, BCLC stage, and hepatitis status between the groups. COX regression analysis showed that BCLC stage, FAR, FLR and PIN were risk factors associated with the prognosis of patients receiving targeted combination immunotherapy for hepatocellular carcinoma, and FLR was an independent risk factor associated with the prognosis of patients receiving targeted combination immunotherapy for hepatocellular carcinoma. Conclusions: We found that peripheral blood markers are promising biomarkers for predicting the prognosis of patients with hepatocellular carcinoma receiving anti-PD-1 combined with targeted therapy, and this study identified FLR as an independent risk factor for the prognosis of patients having advanced hepatocellular carcinoma treated with anti-PD-1 combined with targeted therapy.
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