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Superiority of CRP-albumin-lymphocyte index (CALLY index) as a non-invasive prognostic biomarker after hepatectomy for hepatocellular carcinoma.

IIDA Hiroya 30733901 0000-0001-6245-4583 TANI Masaji 60236677 0000-0003-1270-6003 KOMEDA Koji NOMI Takeo MATSUSHIMA Hideyuki TANAKA Shogo UENO Masaki NAKAI Takuya MAEHIRA Hiromitsu 0000-0003-3064-5216 MORI Haruki 40803945 MATSUI Kosuke HIROKAWA Fumitoshi KAIBORI Masaki 0000-0002-0577-3921 KUBO Shoji 滋賀医科大学

2021.06.22

概要

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

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