Abstract: Objective To examine the alterations in body mass index (BMI), prognostic nutrition index (PNI), neutrophil percentage/albumin ratio (NPAR), as well as their impact on the quality of life among individuals diagnosed with hepatocellular carcinoma (HCC) following nutritional intervention. Methods From May 2021 to July 2023, our hospital treated 128 patients diagnosed with primary HCC. These patients were randomly assorted into a nutrition intervention group (n=64), and a routine rehabilitation group (n=64). All patients underwent standard postoperative rehabilitation procedures, with the nutrition intervention group receiving additional nutritional support through a multi-disciplinary approach to diagnosis and treatment. Various parameters, including general clinical characteristics, liver function indices (including alanine aminotransferase (ALT), aspartate aminotransferase (AST), total protein (TP), albumin (Alb), nutritional status indicators (BMI, PNI, and NPAR), as well as immune function markers (such as the proportion of CD4⁺T cells, CD8⁺T cell ratio, and CD4⁺T/CD8⁺T ratio) were gathered and compared between the two groups both before and after the intervention. Moreover, the impact of the intervention on the patients′ quality of life was assessed using the SF-36 scale. Spearman correlation analysis was employed to explore the relationship between SF-36 scores and changes in indicators of liver function, nutritional status, and immune function post-treatment. Results Following the intervention, the nutrition intervention group exhibited a noticeably higher average CD4⁺T/CD8⁺T cell ratio compared to both pre-intervention levels and the routine rehabilitation group (1.46±0.13 vs 1.38±0.13, P<0.05). Additionally, the average CD4⁺T cell ratio of post-intervention levels was markedly elevated compared to pre-intervention levels, with no significant difference observed between the two groups (P>0.05). Furthermore, after intervention, the average serum TP (43.45±3.50 vs 38.54±3.57) and ALB (35.48±4.08 vs 31.35±3.50) levels showed a significant increase from pre-intervention and the routine rehabilitation group (P<0.05), while serum ALT and AST levels also show a noticeable decvease from pre-intervention levels with no significant variance between the two groups (P>0.05). The average serum BMI (22.93±1.04 vs 21.54±1.03) and PNI (49.35±3.71 vs 44.89±2.92) levels after intervention were significantly higher than those before interventionand in the conventional rehabilitation group, whereas the NPAR (1.30±0.16 vs 1.47±0.15) level showed a significant decrease from pre-treatment and routine rehabilitation levels (P<0.05). The average physical function score (8.64±1.20 vs 7.91±1.11) and overall SF-36 score after intervention exhibited a significant improvement compared to pre-intervention levels and those of the routine rehabilitation group (6.83±1.73 vs 5.98±1.13, P<0.05). Spearman correlation analysis indicated a significant positive correlation between BMI, PNI and the total SF-36 score (r=0.266, 0.304, P<0.05), as well as a significant negative correlation between the NPAR score and SF-36 after HCC treatment (r=-0.322, P<0.05). Conclusion Providing nutritional support after HCC surgery can enhance immune function, liver function, and nutritional status. Patients undergoing nutritional intervention reported improved quality of life, with the extent of enhancement being directly linked to the degree of nutritional recovery. These findings underscore the significant clinical relevance of nutritional intervention for HCC postoperative patients.

Key words: Hepatocellular carcinoma, Nutritional intervention, Prognostic nutritional index, Neutrophil percentage/albumin ratio, Quality of life