Novel inflammation-based model for postoperative early recurrence prediction of hepatitis B virus-related hepatocellular carcinoma ≤ 5 cm

doi:10.3748/wjg.119364

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World Journal of Gastroenterology

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1007-9327

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Retrospective Study

Copyright: ©Author(s) 2026. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution-NonCommercial (CC BY-NC 4.0) license. No commercial re-use. See permissions. Published by Baishideng Publishing Group Inc.

World J Gastroenterol. Jul 7, 2026; 32(25): 119364
Published online Jul 7, 2026. doi: 10.3748/wjg.119364

Table 1 Baseline characteristic of all patients with hepatitis B virus-related hepatocellular carcinoma ≤ 5 cm

Parameter	n = 650
Age (year)	52 (44-60)
≤ 60/> 60	495 (76.2)/155 (23.8)
Sex (female/male)	81 (12.5)/569 (87.5)
Smoking (no/yes)	421 (64.8)/229 (35.2)
Drinking (no/yes)	506 (77.8)/144 (22.2)
Diabetes (no/yes)	593 (91.2)/57 (8.8)
Hypertension (no/yes)	572 (88.0)/78 (12.0)
Cirrhosis (no/yes)	215 (33.1)/435 (66.9)
Anti-HCV (negative/positive)	645 (99.2)/5 (0.8)
HBV-DNA (copy/mL; ≤ 1000/> 1000)	350 (53.8)/300 (46.2)
HBeAg (negative/positive)	564 (86.8)/86 (13.2)
AFP (ng/mL; ≤ 400/> 400)	480 (73.8)/170 (26.2)
Diameter (cm)	3.0 (2.3-3.8)
≤ 3/> 3	335 (51.5)/315 (48.5)
Number (1/2/≥ 3)	516 (79.4)/89 (13.7)/45 (6.9)
Differentiation (well/medium-poor)	123 (18.9)/527 (81.1)
Vascular invasion (no/yes)	582 (89.5)/68 (10.5)
MVI (no/yes)	477 (73.4)/173 (26.6)
Child-Pugh grade (A/B)	629 (96.8)/21 (3.2)
BCLC stage (0/A/B/C)	89 (13.7)/433 (66.6)/59 (9.1)/69 (10.6)
AJCC-TNM, 8^th (I/II/III)	467 (71.8)/169 (26.0)/14 (2.2)
CNLC (I/II/III)	535 (82.3)/47 (7.2)/68 (10.5)
Recurrence (no/early/Late)	353 (54.3)/222 (34.2)/75 (11.5)

The data were showed as n (%) or median (interquartile ranges). HCV: Hepatitis C virus; HBV: Hepatitis B virus; HBeAg: Hepatitis B e antigen; AFP: Alpha-fetoprotein; MVI: Microvascular invasion; BCLC: Barcelona Clinic Liver Cancer; AJCC-TNM: American Joint Committee on Cancer Tumor-Node-Metastasis; CNLC: China Liver Cancer.

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Table 2 Comparison of clinicopathological information and inflammatory indices between the training and validation cohorts

Parameter	Training cohort, n = 390	Validation cohort, n = 260	P value
Age (> 60 years)	82 (21.0)	73 (28.1)	0.039
Sex (male)	336 (86.2)	233 (89.6)	0.191
Smoking (yes)	128 (32.8)	101 (38.8)	0.115
Drinking (yes)	78 (20.0)	66 (25.4)	0.105
Diabetes (yes)	37 (9.5)	20 (7.7)	0.428
Hypertension (yes)	46 (11.8)	32 (12.3)	0.844
Cirrhosis (yes)	258 (66.2)	177 (68.1)	0.610
Anti-HCV (positive)	4 (1.0)	1 (0.4)	0.653
HBV-DNA (copy/mL; > 1000)	180 (46.2)	120 (46.2)	1.000
HBeAg (positive)	53 (13.6)	33 (12.7)	0.741
AFP (ng/mL; > 400)	102 (26.2)	68 (26.2)	1.000
Diameter (cm; > 3)	197 (50.5)	118 (45.4)	0.200
Number (multiple)	71 (18.2)	63 (24.2)	0.063
Differentiation (medium-poor)	314 (80.5)	213 (81.9)	0.653
Vascular invasion (yes)	41 (10.5)	27 (10.4)	0.958
MVI (yes)	90 (23.1)	83 (31.9)	0.012
Child-Pugh grade (B)	9 (2.3)	12 (4.6)	0.103
BCLC stage (B-C)	77 (19.7)	51 (19.6)	0.968
AJCC-TNM, 8^th (II-III)	98 (25.1)	85 (32.7)	0.036
CNLC (II-III)	69 (17.7)	46 (17.7)	1.000
Early recurrence (yes)	136 (34.9)	86 (33.1)	0.636
NLR (> 1.71)	207 (53.1)	134 (51.5)	0.700
PLR (> 71.66)	270 (69.2)	177 (68.1)	0.756
LMR (> 4.83)	126 (32.3)	72 (27.7)	0.210
GPR (> 0.31)	181 (46.4)	148 (56.9)	0.009
PNI (> 49.65)	195 (50.0)	124 (47.7)	0.564
SII (> 323.51)	141 (36.2)	93 (35.8)	0.920
SIRI (> 0.99)	113 (29.0)	86 (33.1)	0.266
APRI (> 0.27)	132 (33.8)	107 (41.2)	0.058
ANRI (> 12.81)	148 (37.9)	115 (44.2)	0.110
ALRI (> 22.16)	136 (34.9)	116 (44.6)	0.012
ALBI (> -2.58)	124 (31.8)	91 (35.0)	0.395
FIB-4 (> 1.67)	220 (56.4)	163 (62.7)	0.111
S-index (> 0.14)	232 (59.5)	173 (66.5)	0.069
AAR (> 0.87)	242 (62.1)	149 (57.3)	0.226

The data were showed as n (%). HCV: Hepatitis C virus; HBV: Hepatitis B virus; HBeAg: Hepatitis B e antigen; AFP: Alpha-fetoprotein; MVI: Microvascular invasion; BCLC: Barcelona Clinic Liver Cancer; AJCC-TNM: American Joint Committee on Cancer Tumor-Node-Metastasis; CNLC: China Liver Cancer; NLR: Neutrophil-to-lymphocyte ratio; PLR: Platelet-to-lymphocyte ratio; LMR: Lymphocyte-to-monocyte ratio; GPR: Gamma-glutamyl transpeptidase-to-platelet ratio; PNI: Prognostic nutritional index; SII: Systemic immune-inflammation index; SIRI: Systemic inflammation response index; ALBI: Albumin-bilirubin index; ALRI: Aspartate aminotransferase to lymphocyte ratio index; ANRI: Aspartate aminotransferase to neutrophil ratio index; APRI: Aspartate aminotransferase to platelet ratio index; FIB-4: Fibrosis index based on four factors; AAR: Aspartate aminotransferase to alanine aminotransferase ratio.

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Table 3 Univariate and multivariate Cox analyses for early recurrence of hepatitis B virus-related hepatocellular carcinoma ≤ 5 cm in the training cohort

Parameters	N = 390, n (%)	Univariate Cox analysis			Multivariate Cox analysis
Parameters	N = 390, n (%)	β	HR (95%CI)	P value	β	HR (95%CI)	P value
Age (> 60 years)	82 (21.0)	0.267	1.306 (0.870-1.961)	0.197
Sex (male)	336 (86.2)	-0.018	0.983 (0.605-1.596)	0.944
Smoking (yes)	128 (32.8)	-0.006	0.994 (0.694-1.424)	0.975
Drinking (yes)	78 (20.0)	-0.033	0.968 (0.631-1.484)	0.881
Diabetes (yes)	37 (9.5)	0.430	1.537 (0.924-2.556)	0.097
Hypertension (yes)	46 (11.8)	-0.005	0.995 (0.590-1.676)	0.984
Cirrhosis (yes)	258 (66.2)	0.208	1.231 (0.856-1.772)	0.262
Anti-HCV (positive)	4 (1.0)	-0.182	0.834 (0.117-5.963)	0.856
HBV-DNA (copy/mL; > 1000)	180 (46.2)	0.064	1.066 (0.762-1.493)	0.708
HBeAg (positive)	53 (13.6)	0.184	1.202 (0.761-1.897)	0.430
AFP (ng/mL; > 400)	102 (26.2)	-0.010	0.990 (0.674-1.455)	0.960
Diameter (cm; > 3)	197 (50.5)	0.499	1.647 (1.171-2.319)	0.004	0.450	1.569 (1.109-2.221)	0.011
Number (multiple)	71 (18.2)	0.693	2.001 (1.366-2.930)	< 0.001	0.641	1.899 (1.293-2.788)	0.001
Differentiation (medium-poor)	314 (80.5)	0.208	1.232 (0.787-1.929)	0.362
Vascular invasion (yes)	41 (10.5)	0.381	1.464 (0.892-2.405)	0.132
MVI (yes)	90 (23.1)	0.649	1.914 (1.322-2.770)	0.001	0.578	1.782 (1.222-2.597)	0.003
Child-Pugh grade (B)	9 (2.3)	-0.035	0.965 (0.307-3.031)	0.952
IRS (high)	190 (48.7)	0.581	1.789 (1.273-2.514)	0.001	0.581	1.787 (1.269-2.516)	0.001
Staging systems
BCLC stage (B-C)	77 (19.7)	0.614	1.848 (1.266-2.697)	0.001
AJCC-TNM, 8^th (II-III)	98 (25.1)	0.516	1.676 (1.172-2.396)	0.005
CNLC (II-III)	69 (17.7)	0.583	1.791 (1.210-2.652)	0.004

HCV: Hepatitis C virus; HBV: Hepatitis B virus; HBeAg: Hepatitis B e antigen; AFP: Alpha-fetoprotein; MVI: Microvascular invasion; IRS: Inflammation-related score; BCLC: Barcelona Clinic Liver Cancer; AJCC-TNM: American Joint Committee on Cancer Tumor-Node-Metastasis; CNLC: China Liver Cancer.

Full Size Table

Citation: Dai TX, Li J, Li H, Wang GY. Novel inflammation-based model for postoperative early recurrence prediction of hepatitis B virus-related hepatocellular carcinoma ≤ 5 cm. World J Gastroenterol 2026; 32(25): 119364
URL: https://www.wjgnet.com/1007-9327/full/v32/i25/119364.htm
DOI: https://dx.doi.org/10.3748/wjg.119364

Dai TX, Li J, Li H, Wang GY. Novel inflammation-based model for postoperative early recurrence prediction of hepatitis B virus-related hepatocellular carcinoma ≤ 5 cm. World J Gastroenterol 2026; 32(25): 119364 [DOI: 10.3748/wjg.119364]

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