Neutrophil-to-lymphocyte ratio associated with mortality in early hepatocellular carcinoma patients after radiofrequency ablation
Neutrophil-to-lymphocyte ratio associated with mortality in early hepatocellular carcinoma patients after radiofrequency ablation
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DOI：
10.1111/j.1440-1746.2011.06910.x
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发表时间：
2012-03-01
影响因子：
4.1
通讯作者：
Wen, Chen-Fan
中科院分区：
文献类型：
--
作者：
Chen, Tsung-Ming;Lin, Chun-Che;Wen, Chen-Fan
背景和目的：越来越多的证据表明肝细胞癌（HCC）患者存在全身性炎症与生存率低相关。我们研究了外周血嗜中性粒细胞淋巴细胞比率（NLR），全身炎症反应的标志物，是否是一个有用的预测结果与早期肝癌患者接受射频消融（RFA）。方法：共158例早期肝癌患者接受RFA。分析了年龄、性别、肿瘤特征、Child-Turcotte-Pugh（CTP）分级和NLR等潜在预后因素。研究的终点是总生存期（OS）和新的复发。结果：我们建模NLR作为一个连续的解释变量回归分析。多变量分析显示肿瘤大小（P = 0.005）和高基线NLR（P = 0.001）是与不良OS相关的独立解释变量。关于新发复发，多变量分析显示CTP B级发现甲胎蛋白> 400 ng/mL（P = 0.030）、肿瘤大小（P = 0.002）和肿瘤多样性（P = 0.013）是较差的预测因子，但不是基线NLR。在首次随访访视时可获得RFA后NLR数据的140例患者的亚组分析中，多变量分析显示，高RFA后NLR被确定为独立协变量，而不仅仅是OS（P = 0.006），但对于新发复发结论：对于早期HCC患者，高基线NLR与更差的OS相关; RFA后NLR不仅预测OS，还预测肿瘤复发。
Background and Aim: Increasing evidence correlates the presence of systemic inflammation with poor survival in patients with hepatocellular carcinoma (HCC). We studied whether peripheral blood neutrophil-to-lymphocyte ratio (NLR), a marker of systemic inflammatory response, would be a useful predictor for outcome in patients with early HCC undergoing radiofrequency ablation (RFA).Methods: A total of 158 patients with early HCC underwent RFA. Potential prognostic factors such as age, gender, tumoral characteristics, Child-Turcotte-Pugh (CTP) class and NLR were analyzed. The study endpoints were overall survival (OS) and new recurrence.Results: We modeled NLR as a continuous explanatory variable in regression analyses. Multivariate analysis revealed that tumor size (P = 0.005) and high baseline NLR (P = 0.001) were independent explanatory variables associated with unfavorable OS. Regarding new recurrence, multivariate analysis showed that CTP class B (P = 0.002), a-fetoprotein > 400 ng/mL (P = 0.030), tumor size (P = 0.002) and tumor multiplicity (P = 0.013) were found to be worse prognosticators, but not baseline NLR. In a subset analysis of 140 patients whose post-RFA NLR data at first follow-up visit were available, multivariate analysis revealed that high post-RFA NLR was identified as an independent covariate, not only for OS (P = 0.006), but for new recurrence (P = 0.010) as well.Conclusions: High baseline NLR was associated with worse OS for patients with early HCC; post-RFA NLR predicted not only OS, but also tumor recurrence.