Prognostic Value Of Systemic Inflammation Response Sir Parameters In Unresectable Hepatocellular Carcinoma

Hepatocellular carcinoma (HCC) is one of the most common malignancies, with increasing incidence and dismal survival. Albumin, globulin, lactate dehydrogenase (LDH), and albumin to globulin ratios (AGR) have been identified as systemic inflammation response (SIR) parameters, correlated with tumor development and metastasis. The aim of this study was to investigate the predictive value of systemic inflammation-related parameters in unresectable hepatocellular carcinoma patients. A total of 101 HCC patients were recruited for this study. Patients had histologic or cytologic evidence of locally advanced stage or metastasis. Patients were divided into two groups, according to the median value of ALB, GLB, LDH, and AGR. Post-/pre-chemotherapeutic ratios were defined as the rate of pre-chemotherapeutic SIR parameters values and corresponding ones obtained after chemotherapy (<= 1 indicates ALB, GLB, LDH, and AGR values were not increased after chemotherapy, while > 1 suggests increased ALB, GLB, LDH, and AGR values). Higher GLB levels are correlated with bone metastasis. Patients with lower baseline LDH levels had better overall survival (OS), whereas ALB, GLB, or AGR levels were not correlated with outcomes. Alterations in LDH levels were associated with therapeutic efficacy. Patients with non-increased LDH levels, following chemotherapy, exhibited improved responses, compared to those with increased LDH levels. Univariate analysis revealed that gender (female), high baseline LDH levels, and non-increased post-/pre-chemotherapy AGR ratios were risk factors affecting OS (overall survival) in patients with HCC. Multivariate analysis indicated that gender (female) and high baseline LDH levels were independent risk factors for HCC prognosis. The area under the curve of baseline LDH was 0.717 (95% CI 0.617-0.818; P < 0.001) and the optimum cutoff point of baseline LDH was 236.500 U/L, with a sensitivity of 73.0% and specificity of 64.6%. The current study shows that baseline LDH levels and changes in AGR levels, after chemotherapy, are correlated with outcomes of patients with HCC.