Value of immunoglobulin G/immunoglobulin M ratio in predicting the prognosis of patients with initially unresectable hepatocellular carcinoma treated by transcatheter arterial chemoembolization combined with tyrosine kinase inhibitor and programmed cell death protein-1 inhibitor

Xingzhi LI; Wei LUO; Yuan FENG; Yu CAI; Xiaohong LIU; Feixiang WU; Yong PENG

doi:10.12449/JCH260114

Volume 42 Issue 1

Jan. 2026

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Article Navigation > Journal of Clinical Hepatology > 2026 > 42(1): 117-124

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Value of immunoglobulin G/immunoglobulin M ratio in predicting the prognosis of patients with initially unresectable hepatocellular carcinoma treated by transcatheter arterial chemoembolization combined with tyrosine kinase inhibitor and programmed cell death protein-1 inhibitor

DOI: 10.12449/JCH260114

Xingzhi LI^{1, 2},
Wei LUO³,
Yuan FENG¹,
Yu CAI¹,
Xiaohong LIU¹,
Feixiang WU²,
Yong PENG^{1
,
,
,}

1.
Department of Hepatobiliary Surgery，Beijing Anzhen Nanchong Hospital of Capital Medical University （Nanchong Central Hospital），Nanchong，Sichuan 637000，China
2.
Department of Hepatobiliary Surgery，Guangxi Medical University Cancer Hospital，Nanning 530021，China
3.
Center for Health Management，Beijing Anzhen Nanchong Hospital of Capital Medical University （Nanchong Central Hospital），Nanchong，Sichuan 637000，China

Research funding:

National Natural Science Foundation of China (82360537);

Key project of Sichuan Primary Health Care Development Research Center (SWFZ24-Z-02)

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Corresponding author: PENG Yong， 13508081615@163.com （ORCID： 0009-0008-4213-6674）
Received Date: 2025-08-22
Accepted Date: 2025-10-15
Published Date: 2026-01-25

Abstract

Abstract

Objective To investigate the association between immunoglobulin G （IgG）/immunoglobulin M （IgM） ratio and prognosis in patients with initially unresectable hepatocellular carcinoma （iuHCC） receiving TTP triple therapy with transcatheter arterial chemoembolization （TACE）， tyrosine kinase inhibitor （TKI）， and programmed cell death protein-1 （PD-1） inhibitors. Methods A retrospective analysis was performed for the clinical data of 151 iuHCC patients who received TTP triple therapy in Department of Hepatobiliary Surgery， Guangxi Medical University Cancer Hospital， from November 2019 to December 2022， and according to IgG/IgM ratio， they were divided into high IgG/IgM group （IgG/IgM ratio >13.23） and low IgG/IgM group （IgG/IgM ratio ≤13.23）. The t-test was used for comparison of continuous data between groups， and the chi-square test was used for comparison of categorical data between groups. The Kaplan-Meier method and the log-rank test were used for survival analysis， and the Cox proportional hazards model was used to investigate the potential influencing factors for overall survival （OS）. Results The 151 patients had a median OS of 26.7 months （95% confidence interval ［CI］： 19.8-not reached） and a median progression-free survival of 12.5 months （95%CI： 10.4 — 15.8）. The objective response rate was 83.4% and the disease control rate was 94.0%. There were no significant differences in baseline data between the high IgG/IgM group and the low IgG/IgM group （all P>0.05）. There was a significant difference in median OS between the high IgG/IgM group and the low IgG/IgM group （20.6 months vs not reached， P=0.016）. In both the high IgG/IgM group and the low IgG/IgM group， salvage hepatectomy was significantly associated with the improvement in OS （χ²=8.297 and 10.307， both P<0.05）. The multivariate analysis showed that high IgG/IgM ratio （hazard ratio ［HR］=1.799， 95%CI： 1.077 — 3.006， P=0.025）， baseline alpha-fetoprotein >400 ng/mL （HR=1.762， 95%CI： 1.017 — 3.050， P=0.043）， and BCLC stage （HR=2.265， 95%CI： 1.212 — 4.232， P=0.010） were independent influencing factors for OS. Conclusion High IgG/IgM ratio is associated with a poorer prognosis in iuHCC patients receiving TTP triple therapy， and salvage hepatectomy has a potential value in improving the prognosis of patients with a high IgG/IGM ratio.
- Carcinoma， Hepatocellular,
- Immunoglobulin G,
- Immunoglobulin M,
- Hepatectomy,
- Prognosis

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References(41)

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Value of immunoglobulin G/immunoglobulin M ratio in predicting the prognosis of patients with initially unresectable hepatocellular carcinoma treated by transcatheter arterial chemoembolization combined with tyrosine kinase inhibitor and programmed cell death protein-1 inhibitor

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Value of immunoglobulin G/immunoglobulin M ratio in predicting the prognosis of patients with initially unresectable hepatocellular carcinoma treated by transcatheter arterial chemoembolization combined with tyrosine kinase inhibitor and programmed cell death protein-1 inhibitor

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