Background: The tumor immune microenvironment and ratios of peripheral blood inflammatory factors have been associated with prognosis in various malignancies. While they show prognostic potential in some cancers, their value in hepatocellular carcinoma (HCC) remains unclear. Methods: We analyzed 371 HCC patients from The Cancer Genome Atlas (TCGA) and a retrospective cohort from Xijing Hospital. Optimal cut-off values for the lymphocyte-to-monocyte ratio (LMR), prognostic nutritional index (PNI), and platelet-to-lymphocyte ratio (PLR) were determined using ROC curve analysis. Associations with clinicopathological features and disease-free survival (DFS) were assessed using Kaplan-Meier and Cox regression analyses. Results: Kaplan-Meier analysis showed that high CD8+ T cell and NK cell infiltration were associated with favorable outcomes. Univariate analysis identified low PNI (≤ 41.6), low LMR (≤ 2.38), high PLR (> 88.64), age, and lymph node metastasis as significant risk factors for DFS. Multivariate Cox analysis established low PNI, high PLR, and lymph node metastasis as independent prognostic factors. Conclusion: High intratumoral CD8+ T cell and natural killer cell (NK cell) levels correlate with better survival. Preoperative PNI, PLR, and lymph node status are independent prognostic indicators for HCC patients. Keywords: peripheral blood inflammatory markers, clinicopathological features, hepatocellular carcinoma, prognosis
Sun et al. (Wed,) studied this question.