Prognostic value of immune-inflammation and nutritional indices in advanced hepatocellular carcinoma patients receiving immunotherapy with compound Kushen injection

Table 1 Demographic information and tumor characteristics of patients (n = 112), n (%)

Characteristics	Treatment group (n = 58)	Control group (n = 54)	P value
WBC (109/L), mean ± SD	6.87 ± 6.60	7.15 ± 4.44	0.796
Neutrophil (109/L), mean ± SD	66.26 ± 15.58	69.9 ± 14.86	0.209
Lymphocyte (109/L), mean ± SD	1.15 ± 0.41	0.98 ± 0.51	0.060
Monocyte (109/L), mean ± SD	0.64 ± 0.44	0.89 ± 1.74	0.309
Age (year), mean ± SD	63.98 ± 10.17	67.4 ± 11.91	0.097
Sex			0.056
Male	42 (72.4)	7(13.0)
Female	16 (27.6)	47(87.0)
HBV			0.054
Yes	18 (31)	27 (50)
No	40 (69)	27 (50)
Child-Pugh grade			0.076
A	45 (77.6)	26 (48.1)
B	13 (22.4)	28 (51.9)
ECOG-PS			0.249
0	12 (20.7)	9 (16.7)
1	39 (67.2)	32 (59.3)
2	7 (12.1)	12 (24.1)
Tumor size (cm)			0.938
≥ 5	20 (34.5)	19 (35.2)
< 5	38 (65.5)	35 (64.8)
Lenvatinib/sorafenib treatment			0.982
Yes	46 (79)	43 (80)
No	12 (21)	11(20)

WBC: White blood cell; HBV: Hepatitis B virus; ECOG-PS: Eastern Cooperative Oncology Group Performance Status.

Table 2 The tumor response and the systemic immune-inflammation and nutritional indices score, n (%)

Treatment response	SII-PNI score			P value
	0 (n = 83)	1 (n = 14)	2 (n = 15)
Non-PD (n = 75)	63 (75.9)	9 (64.3)	3 (20.0)	< 0.0001
PD (n = 37)	20 (24.0)	5 (35.7)	12 (80.0)

PD: Progressive disease; SII: Systemic immune-inflammation index; PNI: Prognostic nutritional index.

Table 3 Ascites status and the systemic immune-inflammation and nutritional indices score, n (%)

AS status	SII-PNI score			P value
	0 (n = 83)	1 (n = 14)	2 (n = 15)
Non-AS (n = 87)	71 (85.5)	12 (85.7)	4 (26.7)	< 0.0001
AS (n = 25)	12 (14.5)	2 (14.3)	11 (73.3)

AS: Ascites; SII: Systemic immune-inflammation index; PNI: Prognostic nutritional index.

Table 4 Univariate and multivariate analysis of the clinicopathological characteristics

Independent factor	OS		PFS
	HR (95%CI)	P value	HR (95%CI)	P value
Univariate analysis
Age	1.108 (0.635-1.934)	0.718	1.296 (0.732-2.296)	0.374
Sex	1.03 (0.572-1.857)	0.921	1.263 (0.691-2.309)	0.443
Albumin	0.907 (0.832-0.988)	0.028	0.913 (0.849-0.982)	0.015
WBC	0.999 (0.956-1.044)	0.959	1.008 (0.973-1.044)	0.685
Neutrophil	1.194 (1.062-1.343)	0.008	1.107 (0.991-1.236)	0.102
Lymphocyte	1.064 (0.559-2.023)	0.851	0.765 (0.404-1.447)	0.407
Monocyte	0.759 (0.349-1.649)	0.460	0.653 (0.313-1.365)	0.205
AFP	0.97 (0.517-1.850)	0.948	0.907 (0.474-1.738)	0.768
HBV	1.83 (0.898-3.730)	0.116	0.865 (0.425-1.761)	0.686
Child-Pugh grade	1.629 (0.836-3.176)	0.169	1.688 (0.866-3.289)	0.141
Tumor size	1.096 (0.623-1.928)	0.750	1.096 (0.623-1.928)	0.750
ECOG performance status	1.505 (0.628-3.607)	0.382	0.535 (0.207-1.336)	0.142
SII	1.004 (1.000-1.007)	0.031	1.005 (1.002-1.008)	0.002
PNI	0.944 (0.882-1.012)	0.105	0.927 (0.871-0.987)	0.016
AS	3.175 (1.182-8.530)	0.042	20.308 (3.783-109.043)	0.000
Multivariate analysis
Albumin	0.895 (0.804-0.995)	0.041	0.962 (0.833-1.111)	0.597
AS	1.21 (11.4-0.986)	0.053	2.764 (1.967-2.602)	0.003
PNI	1.002 (0.998-1.006)	0.403	1.003 (0.999-1.007)	0.131
SII	1.043 (0.920-1.181)	0.512	1.000 (0.881-1.134)	0.999
SII-PNI	2.357 (1.458-2.433)	0.000	0.626 (6.572-0.532)	0.197

OS: Over survival; PFS: Progression-free survival; HR: Hazard ratio; WBC: White blood cell; AFP: Alpha fetoprotein; HBV: Hepatitis B virus; CI: Confidence interval; AS: Ascites; SII: Systemic immune-inflammation index; PNI: Prognostic nutritional index.