血清PLT、AFR联合影像指标对中晚期HCC免疫治疗效果的预测价值分析OA

Objective To investigate the predictive value of peripheral blood platelet count(PLT)and the albumin-to-fibrinogen ratio(AFR)combined with imaging parameters for immunotherapy efficacy in patients with intermediate-to-advanced hepatocellular carcinoma(HCC).Methods Clinical data of 100 patients with intermediate-to-advanced HCC treated at the First Affiliated Hospital of Nanyang Medical College from January 2021 to December 2023 were retrospectively collected.According to the treatment regimen(whether immunotherapy was administered),patients were assigned to an immunotherapy group(n=50)and a control group(n=50).Baseline characteristics,treatment regimens,and efficacy-related indicators were compared between the two groups,including serum PLT level,AFR value,imaging-based tumor volume reduction rate,objective response rate(ORR),and disease control rate(DCR).Progression-free survival(PFS)and overall survival(OS)were evaluated using the Kaplan-Meier method.Receiver operating characteristic(ROC)analysis was performed to assess the prognostic predictive value of PLT,AFR,and imaging parameters(tumor volume reduction rate).Results There were no statistically significant differences in baseline characteristics between the two groups(P＞0.05),indicating comparability.The immunotherapy group had significantly higher ORR and DCR than the control group(P＜0.05).Median PFS and OS were significantly prolonged in the immunotherapy group compared with the control group(P＜0.05).Imaging analysis showed that tumor volume reduction was significantly greater in the immunotherapy group than in the control group(P＜0.05).Correlation analysis revealed that baseline PLT level was negatively correlated with tumor volume reduction rate(P＜0.05),whereas AFR was positively correlated with tumor volume reduction rate(P＜0.05).ROC analysis demonstrated that PLT,AFR,and tumor volume reduction rate each had good predictive value for 18-month survival outcomes(P＜0.05).The combined prediction model showed the highest predictive performance,with an AUC of 0.846(95%CI 0.772～0.920)(P＜0.05).Conclusion Serum PLT and AFR combined with imaging findings may serve as important predictive reference factors for immunotherapy efficacy in patients with intermediate-to-advanced HCC.After hospital admission,appropriate application of these indicators may help clinicians more accurately identify patients who are likely to benefit when making immunotherapy decisions,thereby optimizing treatment strategies and improving patient prognosis.