Postoperative neutrophil-to-lymphocyte ratio change predicts survival of patients with small hepatocellular carcinoma undergoing radiofrequency ablation.
Postoperative neutrophil-to-lymphocyte ratio change predicts survival of patients with small hepatocellular carcinoma undergoing radiofrequency ablation.
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DOI：
10.1371/journal.pone.0058184
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发表时间：
2013
期刊：
影响因子：
3.7
通讯作者：
Chen M
中科院分区：
文献类型：
--
作者：
Dan J;Zhang Y;Peng Z;Huang J;Gao H;Xu L;Chen M
据报道，术前中性粒细胞与淋巴细胞比值（NLR）升高是肝细胞癌（HCC）患者治疗后的预后因素。然而，术后NLR改变的临床意义尚不清楚。从2005年5月到2008年8月，我们对连续178例接受射频消融（RFA）治疗的小肝癌患者进行了回顾性分析。分别于RFA前3天和RFA后1个月内记录NLR。根据术前NLR和/或术后NLR变化比较基线特征、总生存期（OS）和无复发生存期（RFS）。通过多变量分析评估预后因素。与术前NLR水平相比，术后NLR下降87例，增加91例。两组患者常用临床病理特征无明显差异。NLR降低组1、3、5年OS分别为98.8%、78.6%、67.1%，NLR升高组92.2%、55.5%、35.4% (P<0.001)；RFS分别为94.2%、65.2%、33.8%和81.7%、46.1%、12.4% （P<0.001）。在亚组分析中，术前NLR较低或较高患者的生存可以通过术后NLR的变化更准确地区分。多因素分析显示，术后NLR变化是OS （P<0.001, HR = 2.39, 95%CI 1.53-3.72）和RFS （P = 0.003, HR = 1.69, 95%CI 1.87-8.24）的独立预后因素，而术前NLR变化不是。术后NLR变化是小肝癌患者行RFA的独立预后因素，NLR降低的患者生存率高于NLR升高的患者。
An elevated preoperative neutrophil-to-lymphocyte ratio (NLR) has been reported to be a prognostic factor for hepatocellular carcinoma (HCC) patients after treatment. However, the clinical implication of postoperative NLR change remains unclear. From May 2005 to Aug 2008, a cohort of consecutive 178 small HCC patients treated with radiofrequency ablation (RFA) was retrospectively reviewed. The NLR was recorded within 3 days before and 1 month after RFA. Baseline characteristics, overall survival (OS) and recurrence free survival (RFS) were compared according to preoperative NLR and/or postoperative NLR change. Prognostic factors were assessed by multivariate analysis. Compared with preoperative NLR level, postoperative NLR decreased in 87 patients and increased in 91 patients after RFA. No significant differences were identified between two groups in commonly used clinic-pathologic features. The 1, 3, 5 years OS was 98.8%, 78.6%, 67.1% for NLR decreased group, and 92.2%, 55.5%, 35.4% for NLR increased group respectively (P<0.001); the corresponding RFS was 94.2%, 65.2%, 33.8% and 81.7%, 46.1%, 12.4% respectively (P<0.001). In subgroup analysis, the survival of patients with lower or higher preoperative NLR can be distinguished more accurate by postoperative NLR change. Multivariate analysis showed that postoperative NLR change, but not preoperative NLR, was an independent prognostic factor for both OS (P<0.001, HR = 2.39, 95%CI 1.53–3.72) and RFS (P = 0.003, HR = 1.69, 95%CI 1.87–8.24). The postoperative NLR change was an independent prognostic factor for small HCC patient undergoing RFA, and patients with decreased NLR indicated better survival than those with increased NLR.
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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：
8.8
作者：
Fondevila, C;Metges, J P;Fuster, J;Grau, J J;Palacin, A;Castells, A;Volant, A;Pera, M
通讯作者：
Pera, M
DOI：
10.1111/j.1440-1746.2011.06910.x
发表时间：
2012-03-01
影响因子：
4.1
作者：
Chen, Tsung-Ming;Lin, Chun-Che;Wen, Chen-Fan
通讯作者：
Wen, Chen-Fan
影响因子：
2.9
作者：
Hong, SN;Lee, SY;Joh, JW
通讯作者：
Joh, JW
影响因子：
2.6
作者：
Gomez, D.;Farid, S.;Prasad, K. R.
通讯作者：
Prasad, K. R.