Aim and Objective: Inflammation-related changes in peripheral blood cells and blood
proteins are prognostic factors for survival in hepatocellular carcinoma (HCC), but their usefulness
is limited by an active bacterial infection. This study investigated whether infection interfered with
the predictive value of serglycin, a proteoglycan found in hematopoietic cells, on survival in HCC.
Materials and Methods: Patients with hepatitis B virus (HBV)-induced HCC, 100 without and 30
with a bacterial infection, and 30 healthy adult controls were enrolled retrospectively. Baseline
clinical data collected before treatment with transarterial chemoembolization (TACE) was
evaluated, and serglycin expression was assayed by flow cytometry. Receiver operating
characteristic (ROC) curve analysis identified serglycin cutoff values for patient stratification. Cox
regression and Kaplan–Meier analyses were performed to identify predictors of overall survival
Results: Serglycin levels in peripheral blood cells were higher in both groups of HCC patients than
in the control group. Cholinesterase, lung metastasis, average neutrophil serglycin fluorescence
intensity, and aspartate aminotransferase levels were associated with survival risk. Barcelona
Clinic Liver Cancer stage A was associated with a good prognosis of OS.
Conclusion: The intensity of serglycin fluorescence in peripheral neutrophils was independently
predictive of survival in HCC, and its value was not limited by a bacterial infection. The method
presented here is a simple and feasible way to predict prognosis in HCC patients with TACE.