我们进行了第一次荟萃分析，以确定基线血液生物标志物（如中性粒细胞/淋巴细胞比值（NLR），早期甲胎蛋白（AFP）反应，白蛋白/胆红素（ALBI），AFP，血小板/淋巴细胞比值（PLR），C反应蛋白（CRP），缺乏维生素K诱导的蛋白II（PIVKA-II）和淋巴细胞/单核细胞比值（LMR））在免疫检查点抑制剂（ICIs）治疗的肝细胞癌（HCC）患者中预测意义。我们使用PubMed、Cochrane Library、EMBASE和Google Scholar检索了符合条件的文章，直到2022年11月24日。临床结果包括总生存期（OS），无进展生存期（PFS），客观缓解率（ORR），疾病控制率（DCR）和高进展疾病（HPD）。共纳入44篇文章，涉及5322名患者的荟萃分析结果表明：NLR水平高的患者OS和PFS显著较差（HR：1.951，P＜0.001；HR：1.632，P＜0.001），ORR和DCR较低（OR：0.484，P＜0.001；OR：0.494，P＝0.027），而HPD较高（OR：8.190，P＜0.001）。AFP水平高的患者OS和PFS较短（HR：1.689，P＜0.001；HR：1.380，P＜0.001），DCR较低（OR：0.440，P＜0.001），但ORR无差异（OR：0.963，P＝0.933）。我们还发现，早期AFP反应与非反应者相比，与更好的OS和PFS（HR：0.422，P＜0.001；HR：0.385，P＜0.001），更高的ORR（OR：7.297，P＜0.001）和DCR（OR：13.360，P＜0.001）相关。此外，高ALBI等级与ALBI等级为1的患者相比，明显相关短的OS（HR：2.440，P＝0.009）和PFS（HR：1.373，P＝0.022），较低的ORR（OR：0.618，P＝0.032）和DCR（OR：0.672，P＝0.049）。NLR、早期AFP反应和ALBI是ICIs治疗的HCC患者预后的有用预测因子。版权所有©2023年作者。Elsevier B.V.发表，版权所有。

We conducted the first meta-analysis to identify the predictive significance of baseline blood biomarkers (such as neutrophil to lymphocyte ratio (NLR), early alpha-fetoprotein (AFP) response, albumin-bilirubin (ALBI), AFP, platelet to lymphocyte ratio (PLR), C-reactive protein (CRP), protein induced by vitamin K absence II (PIVKA-II), and lymphocyte to monocyte ratio (LMR)) in hepatocellular carcinoma (HCC) patients treated with immune checkpoint inhibitors (ICIs).Eligible articles were retrieved using PubMed, the Cochrane Library, EMBASE, and Google Scholar by November 24, 2022. Clinical outcomes were overall survival (OS), progression-free survival (PFS), objective response rate (ORR), disease control rate (DCR), and hyperprogressive disease (HPD).A total of 44 articles with 5322 patients were included in this meta-analysis. The pooled results demonstrated that patients with high NLR levels had significantly poorer OS (HR: 1.951, P < 0.001) and PFS (HR: 1.632, P < 0.001), lower ORR (OR: 0.484, P < 0.001) and DCR (OR: 0.494, P = 0.027), and higher HPD (OR: 8.190, P < 0.001). The patients with high AFP levels had shorter OS (HR: 1.689, P < 0.001) and PFS (HR: 1.380, P < 0.001), and lower DCR (OR: 0.440, P < 0.001) than those with low AFP levels, however, there was no difference in ORR (OR: 0.963, P = 0.933). We also found that early AFP response was correlated with better OS (HR: 0.422, P < 0.001) and PFS (HR: 0.385, P < 0.001), higher ORR (OR: 7.297, P < 0.001) and DCR (OR: 13.360, P < 0.001) compared to non-responders. Besides, a high ALBI grade was significantly related to shorter OS (HR: 2.440, P = 0.009) and PFS (HR: 1.373, P = 0.022), lower ORR (OR: 0.618, P = 0.032) and DCR (OR: 0.672, P = 0.049) than those with an ALBI grade 1.The NLR, early AFP response, and ALBI were useful predictors of outcomes in HCC patients treated with ICIs.Copyright © 2023 The Authors. Published by Elsevier B.V. All rights reserved.