Background

We aimed to investigate whether a novel biomarker incorporating albumin, lymphocytes, and CRP can predict the prognosis for hepatocellular carcinoma (HCC) after hepatectomy.

Methods

Between January 2011 and December 2013, 384 patients who underwent hepatectomy in four university hospitals in Japan were investigated as a discovery cohort. The CRP-Albumin-Lymphocyte (CALLY index) was defined as (Albumin × Lymphocyte)/(CRP × 10⁴). Patients with a CALLY index ≥5 (n = 200) were compared to those with an index <5 (n = 184). Next, validation was performed using 267 patients from three other university hospitals (external validation cohort).

Results

The number of TNM Stage III and IV patients was significantly higher in the CALLY <5 group than the ≥5 group (p = 0.003). There was a significant difference in the 5-year survival rate (CALLY ≥5: 71% vs. <5: 46%; p < 0.001). Multivariate analysis identified the CALLY index as an independent factor of overall survival. Similarly, there was a significant difference in the 5-year survival rate between the CALLY ≥5 (73%) and <5 (48%) groups (p < 0.001), and the CALLY index was identified as an independent prognostic factor in the external validation cohort.

Conclusion

The CALLY index derived from CRP, albumin, and lymphocyte values is a promising predictive biomarker for postoperative prognosis of patients with HCC.

中文翻译：

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CRP-白蛋白-淋巴细胞指数（CALLY指数）作为肝细胞癌肝切除术后无创预后生物标志物的优越性

背景

我们旨在研究结合白蛋白、淋巴细胞和 CRP 的新型生物标志物是否可以预测肝切除术后肝细胞癌 (HCC) 的预后。

方法

2011 年 1 月至 2013 年 12 月期间，在日本四所大学医院接受了 384 名接受肝切除术的患者作为发现队列进行了调查。CRP-白蛋白-淋巴细胞（CALLY指数）定义为（白蛋白×淋巴细胞）/（CRP×10 ⁴）。CALLY指数≥5（n = 200）的患者与指数<5（n = 184）的患者进行了比较。接下来，使用来自其他三所大学医院（外部验证队列）的 267 名患者进行验证。

结果

CALLY <5 组的 TNM III 期和 IV 期患者数量显着高于 ≥5 组（p = 0.003）。5 年生存率存在显着差异（CALLY ≥5：71% vs. <5：46%；p < 0.001）。多变量分析将CALLY指数确定为总体生存的独立因素。同样，CALLY ≥5 (73%) 和 <5 (48%) 组之间的 5 年生存率存在显着差异 (p < 0.001)，CALLY 指数被确定为独立预后因素外部验证队列。

结论

源自 CRP、白蛋白和淋巴细胞值的 CALLY 指数是预测 HCC 患者术后预后的有希望的生物标志物。