Elevated preoperative peripheral blood monocyte count predicts poor prognosis for hepatocellular carcinoma after curative resection.
Elevated preoperative peripheral blood monocyte count predicts poor prognosis for hepatocellular carcinoma after curative resection.
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术前外周血单核细胞计数升高预示肝细胞癌根治性切除后预后不良
DOI：
10.1186/1471-2407-14-744
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发表时间：
2014-10-03
期刊：
影响因子：
3.8
通讯作者：
Peng BG
中科院分区：
文献类型：
--
作者：
Shen SL;Fu SJ;Huang XQ;Chen B;Kuang M;Li SQ;Hua YP;Liang LJ;Peng BG
背景外周血单核细胞计数是全身炎症反应的一个易于评估的参数。本研究的目的是确定单核细胞计数是否对肝切除术后肝细胞癌 (HCC) 具有预后作用。方法我们回顾性分析了 2006 年至 2009 年接受肝切除治疗的 351 例 HCC 患者。分析了术前绝对外周单核细胞计数、人口统计学以及临床和病理数据。结果在单变量和多变量分析中，单核细胞计数升高(≥545/mm3)、肿瘤大小≥5 cm、无包膜和多个肿瘤与较差的无病生存 (DFS) 和总生存 (OS) 相关。单核细胞计数<545/mm3的患者的1年、3年和5年DFS率分别为58%、41%和35%，单核细胞计数≥545/mm3的患者分别为36%、23%和21%。相应地，单核细胞计数<545/mm3的1年、3年和5年OS率分别为79%、53%和46%，单核细胞计数≥545/mm3的1年、3年和5年OS率分别为64%、36%和29%。亚组分析表明，乙型肝炎病毒（HBV）感染患者肝切除后的 DFS 明显优于外周血单核细胞计数 <545/mm3 的患者，但在非 HBV 感染患者之间无差异。此外，无论是否存在肝硬化，外周血单核细胞计数<545/mm3的患者的DFS均明显更好。单核细胞计数升高的患者肿瘤往往较大。结论术前单核细胞计数升高是肝切除术后 HCC 患者预后较差的独立预测因子，特别是对于 HBV 感染的患者。对于术前单核细胞计数升高的患者，可以考虑术后辅助治疗。
BackgroundPeripheral blood monocyte count is an easily assessable parameter of systemic inflammatory response. The aim of this study was to determine whether monocyte count was prognostic in hepatocellular carcinoma (HCC) following hepatic resection.MethodsWe retrospectively reviewed 351 patients with HCC treated with hepatic resection from 2006 to 2009. Preoperative absolute peripheral monocyte count, demographics, and clinical and pathological data were analyzed.ResultsOn univariate and multivariate analysis, elevated monocyte counts (≥545/mm3), tumor size ≥5 cm, non-capsulation, and multiple tumors were associated with poor disease-free survival (DFS) and overall survival (OS). The 1-, 3- and 5-year DFS rates were 58%, 41% and 35%, respectively, for patients with monocyte counts <545/mm3, and 36%, 23% and 21% for patients with monocyte counts ≥545/mm3. Correspondingly, the 1-, 3- and 5-year OS rates were 79%, 53% and 46% for monocyte counts <545/mm3, and 64%, 36% and 29% for monocyte counts ≥545/mm3. Subgroup analysis indicated that DFS after hepatic resection in hepatitis B virus (HBV)-infected patients was significantly better in those with a peripheral blood monocyte counts <545/mm3, but it did not differ between patients without HBV infection. In addition, DFS was significantly better for patients with a peripheral blood monocyte count <545/mm3, whether or not cirrhosis was present. Patients with elevated monocyte counts tended to have larger tumors.ConclusionsElevated preoperative monocyte count is an independent predictor of worse prognosis for patients with HCC after hepatic resection, especially for those with HBV infection. Postoperative adjuvant treatment might be considered for patients with elevated preoperative monocyte counts.
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