Nomogram integrating prognostic immune-inflammatory-nutritional score with clinicopathological parameters for predicting post-transplantation outcomes in hepatocellular carcinoma

doi:10.3748/wjg.122971

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World Journal of Gastroenterology

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1007-9327

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Retrospective Cohort Study

Copyright: ©Author(s) 2027. 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. Jan 7, 2027; 33(1): 122971
Published online Jan 7, 2027. doi: 10.3748/wjg.122971

Table 1 Demographics and clinicopathological characteristics of the total cohort, n (%)/median (Q1, Q3)

Variables	All patients (n = 269)	Training set (n = 188)	Validation set (n = 81)	P value
Gender				0.178
Female	47 (17.5)	29 (15.4)	18 (22.2)
Male	222 (82.5)	159 (84.6)	63 (77.8)
Age (years)	53.00 (46.00, 59.00)	53.00 (47.00, 59.00)	52.00 (45.00, 60.00)	0.858
Diabetes				0.449
No	201 (74.7)	138 (73.4)	63 (77.8)
Yes	68 (25.3)	50 (26.6)	18 (22.2)
Hypertension				0.664
No	208 (77.3)	143 (76.6)	64 (79.0)
Yes	61 (22.7)	44 (23.4)	17 (21.0)
HBV positive				0.394
No	221 (82.2)	152 (80.9)	69 (85.2)
Yes	48 (17.8)	36 (19.1)	12 (14.8)
Child-Pugh score				0.593
A-B	179 (66.5)	127 (67.6)	52 (64.2)
C	90 (33.5)	61 (32.4)	29 (35.8)
MELD score	10.73 (6.00, 17.58)	10.82 (6.02, 17.18)	10.46 (5.80, 18.55)	0.831
AFP (ng/mL)	5.10 (2.20, 22.10)	5.30 (2.37, 25.27)	4.20 (1.90, 16.10)	0.180
Tumor number	2.00 (1.00, 3.00)	2.00 (1.00, 3.00)	1.00 (1.00, 3.00)	0.573
Tumor size (cm)	3.50 (2.00, 5.50)	3.00 (2.00, 5.00)	3.50 (2.00, 6.00)	0.421
Differentiation				0.356
I-II	212 (78.8)	151 (80.3)	61 (75.3)
III	57 (21.2)	37 (19.7)	20 (24.7)
MVI				0.245
No	125 (46.5)	83 (44.1)	42 (51.9)
Yes	144 (53.5)	105 (55.9)	39 (48.1)
Lymphocyte (× 10⁹/L)	0.72 (0.40, 1.24)	0.72 (0.42, 1.23)	0.72 (0.36, 1.25)	0.977
Neutrophil (× 10⁹/L)	2.40 (1.42, 4.15)	2.41 (1.41, 4.15)	2.39 (1.46, 4.15)	0.772
Monocyte (× 10⁹/L)	0.26 (0.19, 0.42)	0.26 (0.18, 0.43)	0.26 (0.20, 0.36)	0.489
Platelet (× 10⁹/L)	71.00 (46.00, 129.00)	70.50 (45.50, 131.50)	72.00 (48.00, 126.00)	0.799
Albumin (g/L)	32.97 (29.00, 36.80)	32.77 (28.88, 36.60)	33.54 (29.40, 37.00)	0.531
Total bilirubin (μmol/L)	50.30 (20.90, 112.80)	50.40 (20.60, 107.25)	48.60 (22.50, 119.60)	0.679
PLR	107.14 (66.67, 180.00)	102.39 (71.27, 168.97)	118.92 (60.23, 192.54)	0.580
NLR	3.08 (1.85, 6.23)	3.18 (1.96, 6.22)	2.87 (1.71, 7.15)	0.473
LMR	2.45 (1.50, 4.16)	2.36 (1.45, 4.11)	2.61 (1.56, 4.78)	0.565
SII	246.25 (140.00, 547.50)	261.32 (144.51, 540.70)	232.10 (136.88, 563.22)	0.706
SIRI	0.90 (0.47, 1.90)	0.92 (0.48, 1.82)	0.86 (0.43, 1.94)	0.470
ALBI	-1.66 (-2.16, -1.26)	-1.64 (-2.10, -1.27)	-1.72 (-2.22, -1.21)	0.762
PNI	37.30 (32.65, 42.15)	37.22 (32.65, 41.80)	37.85 (32.90, 43.40)	0.598

HBV: Hepatitis B virus; MELD: Model for end-stage liver disease; AFP: Alpha fetoprotein; MVI: Microvascular invasion; PLR: Platelet-to-lymphocyte ratio; NLR: Neutrophil-to-lymphocyte ratio; LMR: Lymphocyte-to-monocyte ratio; SII: Systemic immune-inflammation index; SIRI: Systemic inflammation response index; PNI: Prognostic nutritional index; ALBI: Albumin-bilirubin index.

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Table 2 Cox regression analysis for overall survival in the training set

Variables	Univariate Cox regression		Multivariate Cox regression
Variables	HR (95%CI)	P value	HR (95%CI)	P value
PIIN score	3.287 (2.283-4.733)	< 0.001^a	3.277 (2.270-4.731)	< 0.001^a
Gender (male vs female)	1.734 (0.937-3.209)	0.080
Age (> 60 years vs ≤ 60 years)	1.225 (0.749-2.003)	0.419
Diabetes (yes vs no)	1.390 (0.870-2.222)	0.168
Hypertension (yes vs no)	0.806 (0.469-1.384)	0.434
HBV positive (yes vs no)	1.169 (0.687-1.989)	0.566
MELD score	1.007 (0.983-1.032)	0.562
Child-Pugh (C vs A-B)	1.334 (0.852-2.088)	0.208
AFP (> 40 ng/mL vs ≤ 40 ng/mL)	3.368 (2.081-5.450)	< 0.001^a	1.972 (1.164-3.339)	0.012^a
Tumor number	1.442 (1.269-1.638)	< 0.001^a	1.294 (1.132-1.480)	< 0.001^a
Tumor size	1.152 (1.095-1.213)	< 0.001^a	1.148 (1.079-1.221)	< 0.001^a
Differentiation (III vs I-II)	3.167 (1.988-5.045)	< 0.001^a	1.978 (1.201-3.256)	0.007^a
MVI (yes vs no)	2.650 (1.655-4.242)	< 0.001^a	1.412 (0.810-2.460)	0.224

^aP < 0.05.

PIIN: Prognostic immune-inflammatory-nutritional; HBV: Hepatitis B virus; MELD: Model for end-stage liver disease; AFP: Alpha fetoprotein; MVI: Microvascular invasion; HR: Hazard ratio; CI: Confidence interval.

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Table 3 Cox regression analysis for disease-free survival in the training set

Variables	Univariate Cox regression		Multivariate Cox regression
Variables	HR (95%CI)	P value	HR (95%CI)	P value
PIIN score	3.140 (2.186-4.510)	< 0.001^a	3.007 (2.099-4.307)	< 0.001^a
Gender (male vs female)	1.707 (0.923-3.156)	0.088
Age (> 60 years vs ≤ 60 years)	1.263 (0.773-2.065)	0.351
Diabetes (yes vs no)	1.406 (0.880-2.245)	0.154
Hypertension (yes vs no)	0.876 (0.514-1.493)	0.627
HBV positive (yes vs no)	1.220 (0.717-2.075)	0.464
MELD score	1.010 (0.985-1.035)	0.448
Child-Pugh (C vs A-B)	1.350 (0.862-2.113)	0.189
AFP (> 40 ng/mL vs ≤ 40 ng/mL)	3.300 (2.043-5.329)	< 0.001^a	1.985 (1.182-3.334)	0.010^a
Tumor number	1.442 (1.268-1.638)	< 0.001^a	1.280 (1.117-1.466)	< 0.001^a
Tumor size	1.149 (1.092-1.208)	< 0.001^a	1.128 (1.064-1.196)	< 0.001^a
Differentiation (III vs I-II)	3.097 (1.944-4.935)	< 0.001^a	1.772 (1.067-2.943)	0.027^a
MVI (yes vs no)	2.679 (1.674-4.287)	< 0.001^a	1.465 (0.842-2.550)	0.177

^aP < 0.05.

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Citation: Huang JC, Wang HX, Zhao Y, Li XL, He Q, Lang R, Zhou L. Nomogram integrating prognostic immune-inflammatory-nutritional score with clinicopathological parameters for predicting post-transplantation outcomes in hepatocellular carcinoma. World J Gastroenterol 2027; 33(1): 122971
URL: https://www.wjgnet.com/1007-9327/full/v33/i1/122971.htm
DOI: https://dx.doi.org/10.3748/wjg.122971

Huang JC, Wang HX, Zhao Y, Li XL, He Q, Lang R, Zhou L. Nomogram integrating prognostic immune-inflammatory-nutritional score with clinicopathological parameters for predicting post-transplantation outcomes in hepatocellular carcinoma. World J Gastroenterol 2027; 33(1): 122971 [DOI: 10.3748/wjg.122971]

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