الفهرس 
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Abstract
Hepatocellular carcinoma (HCC) is a prevalent and deadly tumor that has seen significant advancements in its treatment in recent years. Improved comprehension of the tumor’s inherent progression and the creation of staging systems, such as the BCLC (Barcelona Clinic Liver Cancer) system, which classifies patients according to tumor properties, liver disease, and performance status, have led to enhanced prognosis prediction and more appropriate treatment approaches. Presently, therapeutic interventions like as resection, transplantation, and ablation have the potential to improve the survival rate of persons diagnosed with early-stage hepatocellular carcinoma (HCC) and offer the prospect of a long-term cure. Patients at the intermediate stage of hepatocellular carcinoma (HCC) have favorable results with chemoembolization. On the other hand, individuals diagnosed with advanced-stage HCC derive advantages from sorafenib, a multi-kinase inhibitor that has antiangiogenic and antiproliferative properties.
The main objective of this study is to use the ALT/AST ratio and modified NUTRIC score as dependable indicators for forecasting the progression of disease in patients with hepatocellular carcinoma who are undergoing systemic therapy.
The present study included 110 patients diagnosed with hepatocellular carcinoma (HCC) who were at BCLC stage B or C and underwent systemic therapy from January 2023 to December 2023.
The mean age of patients diagnosed with hepatocellular carcinoma (HCC) was 45.5 ± 15.8. The male population accounted for around 77% of the patients, whereas the female population accounted for 23%, resulting in a male-to-female ratio of 3.4:1. There was a substantial reduction in the number of focus regions following the treatment in comparison to prior to the treatment. During a timeframe of 3 months and 28 days, level 3 had a higher mortality rate compared to the other levels, as seen by the De Ritis ratio.
Concerning the distribution of NUTRIC scores among HCC patients, the majority of cases (92.7%) exhibited low NUTRIC scores, while only a small proportion (7.3%) had high NUTRIC scores. Patient mortality rates at 28 days and 3 months were significantly elevated in those with a high NUTRIC score, reaching 57.1% and 37.5% respectively. Among patients with a high NUTRIC score, 87% had alpha feto protein levels exceeding 400, while only 52% of patients with a low NUTRIC score had levels above this threshold.
Ultimately, the ALT/AST ratio and modified NUTRIC score can serve as reliable indicators of disease progression in patients with hepatocellular carcinoma who are receiving systemic therapy. These measures enable the classification of patients based on prognosis, facilitating personalized treatment and monitoring.