Prognostic value of C-reactive protein and neutrophil-to-lymphocyte ratio in patients with hepatocellular carcinoma.
Prognostic value of C-reactive protein and neutrophil-to-lymphocyte ratio in patients with hepatocellular carcinoma.
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DOI：
10.1186/1471-2407-13-78
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发表时间：
2013-02-15
期刊：
影响因子：
3.8
通讯作者：
Lee S
中科院分区：
文献类型：
--
作者：
Oh BS;Jang JW;Kwon JH;You CR;Chung KW;Kay CS;Jung HS;Lee S
越来越多的证据表明，全身炎症反应的组分，如C-反应蛋白（CRP）和嗜中性粒细胞与淋巴细胞比率（NLR），已与各种癌症的预后。我们的目的是阐明CRP和NLR是否可以作为肝细胞癌（HCC）患者缓解和生存的潜在替代标志物。研究人群包括318例连续的HCC患者。在基线时测量CRP和NLR，并进行随访测量。平均随访13.9个月，中位生存时间为13.8个月。Child-Pugh分级、肿瘤直径> 5cm、肿瘤多样性、门静脉血栓形成、甲胎蛋白> 200 ng/mL、CRP > 6.3mg/L、NLR > 2.3是影响HCC生存率的独立因素（均P < 0.05）。CRP升高（> 6.3 mg/L）和NLR升高（> 2.3）的患者的总生存期显著短于CRP低和NLR低的患者（均p < 0.001）。CRP和NLR的联合使用提供了更多的预后信息。随着Child-Pugh分级从A级加重至C级或肿瘤分期从I期进展至IV期，CRP和NLR水平升高，具有显著的相互关系。基线和连续测量的CRP和NLR对治疗反应有很好的预测作用（p < 0.001）。CRP和NLR是HCC患者生存的独立指标，反映了肿瘤负荷和肝脏储备。当联合使用时，它们在预测肿瘤反应和生存方面的作用更强。本研究提示CRP和NLR是HCC重要的预后生物标志物。
Accumulating evidence indicates that components of the systemic inflammatory response, such as C-reactive protein (CRP) and neutrophil-to-lymphocyte ratio (NLR), have been associated with prognosis of various cancers. We aimed to elucidate whether CRP and NLR could serve as potential surrogate markers for response and survival in patients with hepatocellular carcinoma (HCC). The study population consisted of 318 consecutive patients with HCC. CRP and NLR were measured at baseline with follow-up measurements. With the mean follow-up of 13.9 months, the median survival time was 13.8 months. Child-Pugh class, tumor size > 5 cm, tumor multiplicity, presence of portal vein thrombosis, α-fetoprotein > 200 ng/mL, CRP > 6.3 mg/L and NLR > 2.3 were identified as independent factors for worse survival of HCC (all p < 0.05). Patients with elevated CRP (> 6.3 mg/L) and elevated NLR (> 2.3) had a significantly shorter overall survival than those with low CRP and low NLR (all p < 0.001). The combined use of CRP and NLR provided incremental prognostic information. With significant inter-correlations, levels of CRP and NLR escalated with aggravating Child-Pugh class from A to C or progressing tumor stage from I to IV. CRP and NLR on baseline and serial measurements were well predictive of treatment response (p < 0.001). CRP and NLR are independent indicators for survival in HCC patients, reflecting tumor burden and hepatic reserve. Their role in predicting tumor response and survival is more enhanced when used in combination. This study suggests that CRP and NLR are important prognostic biomarkers for HCC.
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影响因子：
4.7
作者：
Mahmoud, Fade Aziz;Rivera, Nilo I
通讯作者：
Rivera, Nilo I
DOI：
10.1111/j.1440-1746.2004.03575.x
发表时间：
2005-02-01
影响因子：
4.1
作者：
Imai, Y;Kubota, Y;Okazaki, K
通讯作者：
Okazaki, K
影响因子：
8.4
作者：
Eisenhauer, E. A.;Therasse, P.;Verweij, J.
通讯作者：
Verweij, J.
影响因子：
2.8
作者：
Ding, Pei-Rong;An, Xin;Pan, Zhi-Zhong
通讯作者：
Pan, Zhi-Zhong
影响因子：
3.7
作者：
Azab, Basem;Bhatt, Vijaya R.;Widmann, Warren D.
通讯作者：
Widmann, Warren D.