ORIGINAL RESEARCH article
Front. Mol. Biosci.
Sec. Molecular Diagnostics and Therapeutics
Volume 12 - 2025 | doi: 10.3389/fmolb.2025.1640390
This article is part of the Research TopicIntegrative Multi-Omics Approaches for Predicting Immunotherapy Efficacy in Solid TumorsView all 10 articles
Preoperative Serum Inflammatory Markers in the Prognostic Assessment of Hepatocellular Carcinoma Resection in Stages I/II
Provisionally accepted
- Affiliated Hospital of North Sichuan Medical College, Nanchong, China
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Background: Hepatocellular carcinoma (HCC) remains a global health challenge, with early-stage resection offering the best chance for improved outcomes. However, limitations of the TNM staging system highlight the need for additional prognostic tools. This study evaluates the prognostic value of preoperative serum inflammatory markers in patients with stage I/II HCC undergoing surgical resection.Methods: A retrospective cohort study was conducted on 410 HCC patients (stage I/II) who underwent surgical resection at the Affiliated Hospital of North Sichuan Medical College between November 2011 and March 2020. Clinical and serological data, including neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and platelet-to-neutrophil ratio (PNR), were analyzed. Prognostic factors for overall survival (OS) were identified through univariate and multivariate Cox regression analyses. A nomogram was developed to predict 1-year, 3-year, and 5year OS, with its performance assessed using ROC curves, calibration plots, and decision curve analysis (DCA). Kaplan-Meier survival curves were used to compare risk groups, and the model's predictive efficacy was evaluated against the AJCC 8th Edition TNM staging system.: Multivariate Cox regression identified NLR, PLR, ALBI score, AFP levels, and HBeAg status as independent prognostic factors for OS. The nomogram demonstrated superior discriminatory power (AUC: 0.78, 0.74, and 0.71 for 1-, 3-, and 5-year OS, respectively) compared to TNM staging. Kaplan-Meier analysis revealed significantly worse OS in the high-risk group (logrank p < 0.001). The nomogram outperformed the AJCC TNM system in both discrimination and clinical utility, as validated by decision curve analysis and the Integrated Discrimination Improvement Index. Conclusions: Preoperative serum inflammatory markers, when integrated with traditional TNM staging, significantly improve prognostic accuracy for stage I/II HCC patients undergoing surgical resection. The developed nomogram provides a practical tool for individualized risk stratification and may guide postoperative management to improve patient outcomes.
Keywords: Hepatocellular Carcinoma, serum inflammatory markers, Prognostic assessment, nomogram, overall survival
Received: 03 Jun 2025; Accepted: 19 Jul 2025.
Copyright: © 2025 Liu, Xiang, Xu and Xu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Xiaoxue Xu, Affiliated Hospital of North Sichuan Medical College, Nanchong, China
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