Inflammation-Based Prognostic Scores in Patients with Hepatitis B Virus-Related Hepatocellular Carcinoma After Liver Transplantation
Inflammation-Based Prognostic Scores in Patients with Hepatitis B Virus-Related Hepatocellular Carcinoma After Liver Transplantation
复制标题
乙型肝炎病毒相关肝细胞癌肝移植术后患者基于炎症的预后评分
DOI：
10.2147/jhc.s259992
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发表时间：
2020-01-01
影响因子：
4.1
通讯作者：
Ma, Yi
中科院分区：
文献类型：
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作者：
Ren, Ao;Li, Zhongqiu;Ma, Yi
背景：基于炎症的预后评分包括全身免疫炎症指数（SII）、血小板与淋巴细胞比值（PLR）和中性粒细胞与淋巴细胞比值（NLR）在各种癌症中具有预后价值。我们研究了SII、PLR和NLR在乙肝相关肝细胞癌（HCC）接受肝移植（LT）患者中的预后价值。方法：我们回顾性分析189例hbv相关HCC患者行肝移植的记录。采用受试者工作特征（ROC）曲线确定最佳SII、PLR和NLR截止值。计算术后总生存期（OS）和无复发生存期（RFS）。采用Kaplan-Meier法和Cox比例风险模型评价SII、PLR和NLR的预后价值。结果：高SII组1、3、5年OS率（分别为74.1%、34.2%、32.3%）明显低于低SII组（分别为78.5%、66.9%、59.9%,p = 0.000）。高SII组1、3、5年RFS分别为75.9%、59.7%、49.4%，低SII组为93.3%、80.2%、73.7% （p = 0.000）。最后，用Kaplan-Meier法绘制OS曲线，并用Log rank检验进行比较。高PLR和NLR评分也与较差的OS （p = 0.000和p = 0.003）和较差的RFS （p = 0.000和p = 0.000）相关。多因素分析显示，AFP >= 400 ng/mL， MELD评分高，最大肿瘤大小>= 5cm, SII >= 449.61, NLR >= 5.29, PLR >= 98.52是OS的独立预后因素。结论：高SII、PLR和NLR是影响hbv相关肝癌肝移植术后总生存率和无复发生存率的显著不良预后因素。
Background: Inflammation-based prognostic scores including systemic immune-inflammation index (SII), platelet to lymphocyte ratio (PLR) and neutrophil to lymphocyte ratio (NLR) have prognostic value in various cancers. We investigated the prognostic value of SII, PLR and NLR in patients who underwent liver transplantation (LT) for HBV-related hepatocellular carcinoma (HCC).Methods: We retrospectively analyzed the records of 189 patients who underwent LT for HBV-related HCC. The receiver operating characteristic (ROC) curve was used to determine the optimal SII, PLR and NLR cut-off value. Overall survival (OS) and recurrence-free survival (RFS) following LT were calculated. The Kaplan-Meier method and the Cox proportional hazards model were used to evaluate the prognostic value of SII, PLR and NLR.Results: The 1-, 3-, and 5-year OS rates were significantly lower in the high SII group (74.1%, 34.2%, and 32.3%, respectively) than in the low SII group (78.5%, 66.9%, and 59.9%, respectively; p = 0.000). The 1-, 3-, and 5-year RFS rates were, respectively, 75.9%, 59.7%, and 49.4% in the high SII group and 93.3%, 80.2%, and 73.7% in the low SII group (p = 0.000). Finally, OS curves were plotted by the Kaplan-Meier method and compared using the Log rank test. High PLR and NLR scores were also associated with poor OS (p = 0.000 and p = 0.003) and poor RFS (p = 0.000 and p = 0.000). The multivariate analysis demonstrated that AFP >= 400 ng/mL, high MELD score, largest tumor size >= 5cm, SII >= 449.61, NLR >= 5.29, and PLR >= 98.52 were independent prognostic factors for OS.Conclusion: High SII, PLR and NLR are significantly poor prognostic factors for overall survival and recurrence-free survival in patients with HBV-related hepatocellular carcinoma after liver transplantation.