[摘 要] 目的：探究中性粒细胞/淋巴细胞比值（NLR）、血小板/淋巴细胞比值（PLR）、淋巴细胞/单核细胞比值（LMR）及预后营 养指数（PNI）对免疫检查点抑制剂（ICI）联合抗血管生成药物治疗晚期肝细胞癌（HCC）患者疗效及预后的预测价值。方法:收集 2020年1月至2023年12月间在大理大学第一附属医院收治的使用ICI联合抗血管生成药物治疗的85例晚期HCC患者的一般临 床资料、治疗前患者的NLR、PLR、LMR、PNI、临床疗效及预后。采用受试者工作特征（ROC）曲线计算NLR、PLR、LMR、PNI的最 佳截断值，以此将患者分成高、低2组。使用Kaplan-Meier法绘制生存曲线，采用Cox比例风险回归模型进行单因素、多因素分析 各指标对患者OS的影响。结果:低NLR组、低PLR组、高LMR组、高PNI组患者治疗有效率均分别高于高NLR组、高PLR组、低 LMR组和低PNI组（均P < 0.05）。低NLR组、低PLR组患者OS率均分别显著高于高NLR组、高PLR组（均P < 0.05）；高LMR 组、高PNI组患者OS率均分别显著高于低LMR组和低PNI组（均P < 0.05）。NLR ≥ 1.94、男性、乙型肝炎病毒感染是晚期HCC患 者预后的独立危险因素（均P < 0.05）。结论: NLR ≥ 1.94、男性、乙型肝炎病毒阳性是影响患者疗效、预后的危险因素，NLR ≥ 1.94 评估晚期HCC患者免疫联合靶向的疗效及预后有一定的临床价值。

[Abstract] Objective: To investigate the value of neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), lymphocyte monocyte ratio（LMR）and prognostic nutrition index (PNI) in predicting the curative effect and prognosis of patients with advanced hepatocellular carcinoma(HCC) treated with combined therapy of immune checkpoint inhibitors (ICI) and antiangiogenic drugs. Methods: The general clinical data, NLR, PLR, LMR and PNI of patients before treatment, clinical efficacy and prognosis of 85 advanced HCC patients admitted and treated with combined therapy of ICI and antiangiogenic drugs between January 2020 and December 2023 in the First Affiliated Hospital of Dali University were collected. The optimal cut-off values of NLR、PLR、LMR and PNI were obtained using receiver operating characteristic (ROC) curve, and used to divide the patients into the high and low groups. Kaplan-Meier method was used for survival analysis; Cox proportional risk model was used for the univariate and multivariate analysis of the effects of these values on the patient's OS. Results: The therapeutic effective rates in the low NLR，low PLR，high LMR and high PNI groups were respectively higher than those of the high NLR, high PLR, low LMR and low PNI groups (all P < 0.05). The patient's OS rates in the low NLR, low PLR groups were respectively significantly higher than those in the high NLR, high PLR groups (all P < 0.05). The patient’s OS rates in the high LMR, high PNI groups were respectively significantly higher than those in the low LMR, low PUI groups (all P < 0.05). NLR ≥ 1.94, male and HBV infection were independent risk factors for the prognosis of advanced HCC patients (all P < 0.05). Conclusion: NLR ≥ 1.94, male, HBV positive are risk factors influencing the efficacy and prognosis of patients. NLR ≥ 1.94 has certain clinical value in evaluating the efficacy and prognosis of combined immunotherapy and targeted therapy for advanced HCC patients.