Evaluation value of NLR combined with ALBI score for outcomes of TACE in patients with unresectable hepatitis B-related hepatocellular carcinoma

LI Hu; HUANG Yongping; MIAO Jun; XING Liju

doi:10.3969/j.issn.1007-8134.2025.02.002

Abstract：Objective To investigate the evaluation value of the neutrophil-to-lymphocyte ratio(NLR)combined with the albumin-bilirubin(ALBI)score for predicting the outcome of transcatheter arterial chemoembolization(TACE)in patients with unresectable hepatitis B-related hepatocellular carcinoma(HCC).Methods A total of 152 patients with unresectable hepatitis B-related HCC who underwent TACE in Jiangyin Traditional Chinese Medicine Hospital from January 2021 to August 2023(HCC group)and 76 healthy individuals(control group)were included.Based on 1-year post-TACE outcomes,HCC patients were divided into a adverse outcome group(n=62)and a good outcome group(n=90).NLR and ALBI scores were calculated.Correlations between NLR,ALBI scores,and clinical characteristics of unresectable hepatitis B-related HCC patients were analyzed using Pearson or Spearman correlation analysis.Multivariate unconditional logistic regression was used to analyze the relationship between NLR,ALBI scores,and TACE outcomes.The receiver operating characteristic(ROC)curve was used to evaluate the predictive value of NLR combined with ALBI scores for TACE outcomes.Results Compared with the control group,NLR and ALBI scores were significantly higher in the HCC group(P＜0.05).In unresectable hepatitis B-related HCC patients,NLR and ALBI scores were positively correlated with China Liver Cancer(CNLC)stage and tumor differentiation degree(P＜0.05).After 1 year of follow-up,the adverse outcome rate of TACE treatment in 152 unresectable hepatitis B-related HCC patients was 40.79％(62/152).Compared with the good outcome group,the adverse outcome group had significantly higher NLR and ALBI scores(P＜0.05).CNLC stage Ⅲa-Ⅲb,poor differentiation,vascular invasion,high NLR,and high ALBI scores were independent risk factors for adverse TACE outcomes in patients with unresectable hepatitis B-related HCC(P＜0.05).The area under the curve(AUC)for NLR combined with ALBI scores in predicting TACE outcomes was 0.848,which was higher than the AUCs for NLR(0.766)and ALBI scores(0.757)alone(P＜0.05).Conclusions Elevated NLR and ALBI scores are associated with poor outcomes in patients with unresectable hepatitis B-related HCC after TACE treatment.The combination of NLR and ALBI scores has high evaluation value for predicting TACE outcomes.