Background: The preoperative circulating tumor cell (CTC) status and pan-immune-inflammation value (PIV) are associated with poor prognosis of hepatocellular carcinoma (HCC). The aim of the present study is to determine whether the combination of CTC and PIV (CTC-PIV) could better predict the recurrence of HCC patients treated with curative resection.
Methods: Preoperative PIV was retrospectively calculated in 141 HCC patients who underwent curative resection at the Fourth Hospital of Hebei Medical University from 2020 to 2023. Preoperative CTC counts were enumerated from 5 ml peripheral vein blood and performed by the Cyttel method. According to the preoperative CTC status and PIV, the patients were divided into three groups: CTC-PIV (0), CTC-PIV (1) and CTC-PIV (2). The relationship between CTC and PIV, as well as the associations of CTC-PIV status with clinicopathological factors and survival, were evaluated.
Results: The positive rate of CTC were positively correlated with the preoperative PIV (P=0.008). An elevated CTC-PIV score was significantly associated with male patients (P=0.043). In addition, patients with high CTC-PIV score tended to present with solitary tumors(P=0.071) and elevated AFP levels(P=0.083). Kaplan-Meier analysis and log-rank tests revealed significant decreases in recurrence-free survival (RFS) among HCC patients with CTC-PIV score of 0, 1 and 2 (P=0.009). Further univariate and multivariate analyses showed that CTC-PIV score was the independent factor affecting patients’ RFS.
Conclusion: The preoperative CTC-PIV score is associated with tumor progression in patients with HCC treated with curative resection, indicating that better information on HCC prognosis could be obtained from combined preoperative host immune- inflammation status and CTC detection.