BACKGROUND AND AIMS The aim of the present study is to evaluate a new index influenced by the balance between the immune system, α-fetoprotein (AFP), and lactate dehydrogenase (LDH) (RAPID index) as a prognostic factor in patients treated with sorafenib. METHODS This study was conducted on a training cohort of 159 hepatocellular carcinoma (HCC) patients and a validation cohort of 68 HCC patients treated with sorafenib. The RAPID index was calculated as neutrophil/lymphocyte count × LDH × AFP. RESULTS In the training cohort, the median overall survival (OS) was 23.2 months (95% CI 11-25) and 12.1 months (95% CI 9-15) for patients with a low (≤3,226) and high (>3,226) RAPID index, respectively (ref. <3,226, HR = 0.56, 95% CI 0.35-0.88, p = 0.017). Following adjustment for clinical covariates, multivariate analysis confirmed the RAPID index ≤3,226 versus >3,226 (HR = 0.37, 95% CI 0.18-0.74, p = 0.0054) as an independent prognostic factor for OS. In the validation cohort, the median OS was 26.9 months (95% CI 17.6-26.9) and 7.0 months (95% CI 6.2-9.2) for patients with a low (≤ 3,226) and high (>3,226) RAPID index, respectively (ref. <3,226, HR = 0.19, 95% CI 0.10-0.36, p < 0.0001). Performing the same multivariate analysis of the training cohort (AFP, Eastern Cooperative Oncology Group, aspartate aminotransferase, neutrophil, platelet, systemic inflammatory index and RAPID index), the RAPID index <3,226 versus >3,226 (HR = 3.86, 95% CI 1.45-10.29, p = 0.007) was found to be an independent prognostic factor for predicting OS. CONCLUSION The low cost, easy assessment, and reproducibility of a full blood count make the RAPID index a promising tool for assessing HCC prognosis in future clinical practice.

中文翻译：

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新指数（RAPID 指数）在接受索拉非尼的晚期肝细胞癌患者中的预后作用：培训和验证队列。

背景和目的 本研究的目的是评估一种新的指标，该指标受免疫系统、甲胎蛋白 (AFP) 和乳酸脱氢酶 (LDH) 之间的平衡影响，作为索拉非尼治疗患者的预后因素。 . 方法 本研究在 159 名肝细胞癌 (HCC) 患者的训练队列和 68 名接受索拉非尼治疗的 HCC 患者的验证队列中进行。RAPID指数计算为中性粒细胞/淋巴细胞计数×LDH×AFP。结果 在训练队列中，低 (≤3,226) 和高 (>3,226) 患者的中位总生存期 (OS) 分别为 23.2 个月 (95% CI 11-25) 和 12.1 个月 (95% CI 9-15) RAPID 指数分别为（参考 <3,226，HR = 0.56，95% CI 0.35-0.88，p = 0.017）。在调整临床协变量后，多变量分析证实 RAPID 指数 ≤3,226 与 >3,226（HR = 0.37, 95% CI 0.18-0.74, p = 0.0054）是 OS 的独立预后因素。在验证队列中，RAPID 指数低（≤ 3,226）和高（>3,226）患者的中位 OS 分别为 26.9 个月（95% CI 17.6-26.9）和 7.0 个月（95% CI 6.2-9.2）（参考 <3,226, HR = 0.19, 95% CI 0.10-0.36, p < 0.0001)。对训练队列（法新社、东部肿瘤协作组、天冬氨酸氨基转移酶、中性粒细胞、血小板、全身炎症指数和 RAPID 指数）进行相同的多变量分析，RAPID 指数 <3,226 与 >3,226（HR = 3.86, 95% CI 1.45- 10.29，p = 0.007）被发现是预测 OS 的独立预后因素。结论 成本低，易于评估，