Pretreatment neutrophil-lymphocyte ratio: an independent predictor of survival in patients with hepatocellular carcinoma.
Pretreatment neutrophil-lymphocyte ratio: an independent predictor of survival in patients with hepatocellular carcinoma.
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治疗前中性粒细胞-淋巴细胞比率：肝细胞癌患者生存的独立预测因子。
DOI：
10.1097/md.0000000000000639
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发表时间：
2015-03
期刊：
影响因子：
1.6
通讯作者：
Wang X
中科院分区：
文献类型：
--
作者：
Gao F;Li X;Geng M;Ye X;Liu H;Liu Y;Wan G;Wang X
嗜中性粒细胞与淋巴细胞比率（NLR）已被证明与各种类型癌症的预后相关。我们评估了治疗前NLR作为肝细胞癌（HCC）患者预后不良的预测因子，并将NLR的预后价值与其他预后评分进行了比较。我们回顾性分析了2008年10月至2012年5月期间诊断为HCC的825例患者。治疗前记录基线数据，包括NLR和Child-Pugh分级或终末期肝病模型（MELD）评分。使用单变量和多变量分析以及受试者工作特征（ROC）曲线评估总生存期（OS）与研究变量之间的关系。采用Kaplan-Meier生存分析评估NLR的预后价值，并与临床肝癌（BCLC）和肿瘤、淋巴结、转移（TNM）分期进行比较。NLR、γ-谷氨酰转肽酶、甲胎蛋白≥400 ng/mL、肿瘤个数≥3个、肿瘤大小≥5 cm、淋巴结转移、门静脉受累、Child-Pugh分级与OS显著相关，NLR具有最强的预后价值（ROC曲线下面积= 0.811）。 NLR ≥2.7是预后差的重要预测因子（P <0.0001），NLR ≥2.7的患者生存期随BCLC和TNM分期的进展而缩短。 治疗前NLR是HCC患者有用的预后生物标志物。NLR ≥2.7的预后价值上级优于MELD分期或Child-Pugh分级，并与BCLC和TNM分期评分相关。
The neutrophil-to-lymphocyte ratio (NLR) has been shown to be associated with prognosis in various types of cancer. We evaluated pretreatment NLR as a predictor of poor prognosis in patients with hepatocellular carcinoma (HCC), and we compared the prognostic value of NLR with other prognostic scores. We retrospectively analyzed 825 patients diagnosed with HCC between October 2008 and May 2012. Baseline data, including the NLR and the Child–Pugh class or Model for End-Stage Liver Disease (MELD) score, were recorded before treatment. The relationships between overall survival (OS) and the study variables were assessed using univariate and multivariate analyses and receiver operating characteristic (ROC) curves. The prognostic value of NLR was assessed using a Kaplan–Meier survival analysis and compared with that of the Barcelona-Clinic Liver Cancer (BCLC) and Tumor, Node, Metastasis (TNM) staging. The NLR, γ-glutamyltranspeptidase, α-fetoprotein ≥400 ng/mL, tumor number ≥3, tumor size ≥5 cm, lymph node metastasis, portal vein involvement, and Child–Pugh class were significantly associated with OS. The NLR demonstrated the strongest prognostic value (area under ROC curve = 0.811). An NLR ≥2.7 was a significant predictor of poor OS (P < 0.0001), and the survival period of patients with an NLR ≥2.7 decreased with more advanced BCLC and TNM stage. Pretreatment NLR is a useful prognostic biomarker in HCC patients. The prognostic value of NLR ≥2.7 is superior to that of MELD stage or Child–Pugh class, and correlates with that of BCLC and TNM staging scores.