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已发表论文
TBS-PALB-NLR 三联征：一种指导不可切除肝细胞癌经动脉化疗栓塞治疗决策的新型术前预后系统
Authors Yu B , Xu L, Yang W, Yin Y, Yang J, Miao X , Ni C
Received 15 September 2025
Accepted for publication 11 December 2025
Published 20 December 2025 Volume 2025:12 Pages 2859—2873
DOI https://doi.org/10.2147/JHC.S564976
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 2
Editor who approved publication: Prof. Dr. Imam Waked
Bin Yu, Lin Xu, Weihao Yang, Yu Yin, Jun Yang, Xiaoyun Miao, Caifang Ni
Department of Interventional Radiology, The First Affiliated Hospital of Soochow University, Suzhou, People’s Republic of China
Correspondence: Caifang Ni, Department of Interventional Radiology, The First Affiliated Hospital of Soochow University, Suzhou, People’s Republic of China, Email cjr.nicaifang@vip.163.com
Purpose: This study aimed to investigate the predictive value of the Tumor Burden Score (TBS) combined with Serum Prealbumin (PALB) and the Neutrophil-to-Lymphocyte Ratio (NLR) for the long-term prognosis of patients with unresectable hepatocellular carcinoma (uHCC) following transcatheter hepatic artery chemoembolization (TACE) therapy, and to elucidate its significance in guiding treatment planning.
Patients and Methods: Clinical data from 940 patients with unresectable HCC who underwent TACE treatment at three hospitals in the Jiangsu Province between 2007 and 2018 were retrospectively analyzed. TBS was calculated using the formula: TBS2 = (maximum tumor diameter)2 + (number of tumors)2 (The diameter of the tumor is measured in centimeters). The optimal cutoff values for TBS and NLR were determined using R software. Patients were risk-stratified based on their TBS-PALB-NLR (TPN) score. Independent predictors associated with survival were identified using univariate and multivariate Cox proportional hazards regression analyses.
Results: Independent risk factors identified through univariate Cox analysis included age, cirrhosis, ascites, BCLC stage, vascular invasion, NLR, TBS, PALB, AFP, Bilirubin, AST, and ALT. Multivariate analysis revealed that BCLC stage, NLR, TBS, and PALB were significant independent risk factors affecting overall survival (P < 0.05). The TPN score was established based on TBS, PALB, and NLR, and patients were stratified into low-TPN, intermediate-TPN, and high-TPN groups.
Conclusion: The TPN score is a low-cost, readily available prognostic tool that can effectively risk-stratify patients with uHCC. It may guide personalized adjuvant therapy (eg, systemic therapy for high-risk patients), particularly in resource-limited medical centers.
Keywords: hepatocellular carcinoma, transarterial chemoembolization, tumor burden score, PALB, NLR, prognosis
Department of Interventional Radiology, The First Affiliated Hospital of Soochow University, Suzhou, People’s Republic of China
Correspondence: Caifang Ni, Department of Interventional Radiology, The First Affiliated Hospital of Soochow University, Suzhou, People’s Republic of China, Email cjr.nicaifang@vip.163.com
Purpose: This study aimed to investigate the predictive value of the Tumor Burden Score (TBS) combined with Serum Prealbumin (PALB) and the Neutrophil-to-Lymphocyte Ratio (NLR) for the long-term prognosis of patients with unresectable hepatocellular carcinoma (uHCC) following transcatheter hepatic artery chemoembolization (TACE) therapy, and to elucidate its significance in guiding treatment planning.
Patients and Methods: Clinical data from 940 patients with unresectable HCC who underwent TACE treatment at three hospitals in the Jiangsu Province between 2007 and 2018 were retrospectively analyzed. TBS was calculated using the formula: TBS2 = (maximum tumor diameter)2 + (number of tumors)2 (The diameter of the tumor is measured in centimeters). The optimal cutoff values for TBS and NLR were determined using R software. Patients were risk-stratified based on their TBS-PALB-NLR (TPN) score. Independent predictors associated with survival were identified using univariate and multivariate Cox proportional hazards regression analyses.
Results: Independent risk factors identified through univariate Cox analysis included age, cirrhosis, ascites, BCLC stage, vascular invasion, NLR, TBS, PALB, AFP, Bilirubin, AST, and ALT. Multivariate analysis revealed that BCLC stage, NLR, TBS, and PALB were significant independent risk factors affecting overall survival (P < 0.05). The TPN score was established based on TBS, PALB, and NLR, and patients were stratified into low-TPN, intermediate-TPN, and high-TPN groups.
Conclusion: The TPN score is a low-cost, readily available prognostic tool that can effectively risk-stratify patients with uHCC. It may guide personalized adjuvant therapy (eg, systemic therapy for high-risk patients), particularly in resource-limited medical centers.
Keywords: hepatocellular carcinoma, transarterial chemoembolization, tumor burden score, PALB, NLR, prognosis