Background. Increasing research attention has focused on tumor-infiltrating immune cells. However, the threshold of an immune score for use in predicting overall survival (OS) and disease-free survival (DFS) in hepatocellular carcinoma (HCC) is not defined. This study aims at exploring the association between immune scores with prognosis and building a clinical nomogram for predicting the survival of HCC patients. Material and Methods. A total of 299 patients were enrolled in this study. Their clinical pathological characteristics and immune scores downloaded from The Cancer Genome Atlas (TCGA) database were analyzed. Survival differences between different immune score subgroups were compared, and a final nomogram was built using the Cox proportional hazards regression model. The predictive performance of the nomogram was assessed using the concordance index (C-index) and a calibration plot. Results. All the patients were divided into three subgroups based on immune scores. Patients with medium and high immune scores had significantly better OS (HR and 95% CI: 0.417 [0.186-0.937] and 0.299 [0.146-0.616]) and DFS (HR and 95% CI: 0.575 [0.329-1.004] and 0.451 [0.278-0.733], respectively, compared with those with low immune scores. The C indices for OS and DFS were 0.748 (95% CI, 0.687-0.809) and 0.675 (95% CI, 0.630-0.720), respectively. A calibration plot used to determine the probability of survival at 3 or 5 years (OS and DFS) showed a significant agreement between nomogram predictions and actual observations. Conclusions. Medium and high immune scores are significantly associated with prolonged OS and DFS in HCC patients. Nomograms built in this study can help doctors and patients assess prognosis and guide treatment.

中文翻译：

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基于免疫评分的预后列线图可预测肝细胞癌患者的术后生存率。

背景。越来越多的研究注意力集中在肿瘤浸润性免疫细胞上。然而，用于预测肝细胞癌 (HCC) 总生存期 (OS) 和无病生存期 (DFS) 的免疫评分阈值尚未确定。本研究旨在探索免疫评分与预后之间的关系，并建立临床列线图来预测 HCC 患者的存活率。材料与方法. 共有 299 名患者参加了这项研究。分析他们从癌症基因组图谱（TCGA）数据库下载的临床病理特征和免疫评分。比较不同免疫评分亚组之间的生存差异，并使用 Cox 比例风险回归模型构建最终列线图。使用一致性指数（C-index）和校准图评估列线图的预测性能。结果. 根据免疫评分将所有患者分为三个亚组。中高免疫评分患者的 OS（HR 和 95% CI：0.417 [0.186-0.937] 和 0.299 [0.146-0.616]）和 DFS（HR 和 95% CI：0.575 [0.329-1.004] 和 0.451 [ 0.278-0.733]，与免疫评分低的患者相比，OS 和 DFS 的 C 指数分别为 0.748（95% CI，0.687-0.809）和 0.675（95% CI，0.630-0.720）。用于确定 3 年或 5 年生存概率（OS 和 DFS）的列线图预测与实际观察结果之间存在显着一致性。. 中高免疫评分与 HCC 患者延长 OS 和 DFS 显着相关。本研究中建立的列线图可以帮助医生和患者评估预后并指导治疗。