Preoperative neutrophil-to-lymphocyte ratio as a prognostic predictor after curative resection for hepatocellular carcinoma
Preoperative neutrophil-to-lymphocyte ratio as a prognostic predictor after curative resection for hepatocellular carcinoma
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DOI：
10.1007/s00268-008-9552-6
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发表时间：
2008-08-01
影响因子：
2.6
通讯作者：
Prasad, K. R.
中科院分区：
文献类型：
--
作者：
Gomez, D.;Farid, S.;Prasad, K. R.
背景本研究旨在评估术前嗜中性粒细胞与淋巴细胞比率（NLR）升高对肝细胞癌（HCC）根治性切除术后结局的影响。方法从肝胆数据库中确定1994年1月至2007年5月接受HCC切除术的患者。人口统计学，实验室分析，和组织病理学数据进行了analysed.Results共96例患者的中位年龄在65（范围，15-85）岁的诊断确定。1年、3年和5年总生存率分别为80%、58%和52%。尽管微血管浸润、NLR >= 5和R1切缘的存在是总生存率的不利预测因素，但在多变量分析中没有发现独立的预测因素。1年、3年和5年无病生存率分别为74%、63%和57%。术前肿瘤活检、NLR >= 5、多发性肝肿瘤、微血管侵犯和R1切缘都是无病生存率较差的预测因素。多变量分析显示，NLR >= 5和R1切缘是无病生存率较差的独立预测因素。NLR >= 5的患者的中位无病生存期为8个月，而NLR = 5的患者的中位无病生存期为18个月< 5.Conclusion Preoperative NLR >，这是无病生存期和总生存期的不利预测因素。
Background This study was designed to evaluate the impact of an elevated preoperative neutrophil-to-lymphocyte ratio (NLR) on outcome after curative resection for hepatocellular carcinoma (HCC).Methods Patients undergoing resection for HCC from January 1994 to May 2007 were identified from the hepatobiliary database. Demographics, laboratory analyses, and histopathology data were analyzed.Results A total of 96 patients were identified with a median age at diagnosis of 65 (range, 15-85) years. The 1-, 3-, and 5-year overall survival rates were 80%, 58%, and 52%, respectively. Although the presence of microvascular invasion, NLR >= 5, and R1 resection margin were adverse predictors of overall survival, there were no independent predictors identified on multivariate analysis. The 1-, 3-, and 5-year disease-free survival rates were 74%, 63%, and 57%, respectively. Preoperative tumor biopsy, NLR >= 5, multiple liver tumors, microvascular invasion, and R1 resection margin were all predictors of poorer disease-free survival. Multivariate analysis showed that a NLR >= 5 and R1 resection margin were independent predictors of poorer disease-free survival. The median disease-free survival of those with a NLR >= 5 was 8 months compared with 18 months for those with a NLR < 5.Conclusion Preoperative NLR >= 5 was an adverse predictor of disease-free and overall survival.