Prognostic value of preoperative inflammatory markers in patients with hepatocellular carcinoma who underwent curative resection.
Prognostic value of preoperative inflammatory markers in patients with hepatocellular carcinoma who underwent curative resection.
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术前炎症标志物对接受根治性切除的肝细胞癌患者的预后价值
DOI：
10.1186/s12935-021-02204-3
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发表时间：
2021-09-17
影响因子：
5.8
通讯作者：
Dou K
中科院分区：
文献类型：
--
作者：
Wu W;Wang Q;Han D;Li J;Nie Y;Guo D;Yang L;Tao K;Zhang X;Dou K
肝细胞癌（HCC）的预后不容乐观。我们的研究重点是当前的炎症标志物，包括中性粒细胞与淋巴细胞比值（NLR）、血小板与淋巴细胞比值（PLR）、γ -谷氨酰转肽酶与血小板比值（GPR）、天冬氨酸转氨酶与淋巴细胞比值（ALR）和纤维蛋白原与白蛋白比值（FAR），并探讨它们的最佳组合对肝癌切除术后预后的影响。共纳入347例行根治性切除的HCC患者。采用受试者工作特征（ROC）曲线分析计算炎症标志物的最佳截断值，并将患者分为两组，采用Kaplan-Meier分析比较差异。采用Cox单因素和多因素分析分析独立预后炎症标志物。采用χ2检验确定独立预后炎症标志物与临床病理特征的关系。我们建立了组合评分模型，并通过Cox单变量和多变量方法对其进行评估。计算一致性指数（C-index）、赤池信息准则（Akaike information criterion， AIC）和似然比对模型进行比较。通过Kaplan-Meier分析，对选择的最佳炎症标志物及其组合在HCC的不同阶段进行检测。ALR和GPR是无病生存（DFS）的独立预后因素；ALR、PLR和GPR是总生存期（OS）的独立预后因素。提出的GPR和ALR-GPR-PLR评分模型分别是DFS和OS的独立预测因子。术前GPR和ALR-GPR-PLR评分模型分别是DFS和OS的独立预测因子，在HCC患者分层中表现良好。模型得分越高，预后越差。在线版本包含补充材料，下载地址：10.1186/s12935-021-02204-3。
The prognosis of hepatocellular carcinoma (HCC) is not optimistic. Our study focused on present inflammatory markers, including the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), gamma-glutamyl transpeptidase-to-platelet ratio (GPR), aspartate aminotransferase-to-lymphocyte ratio (ALR) and fibrinogen-to-albumin ratio (FAR), and explored their optimal combination for the prognosis of HCC after resection. A total of 347 HCC patients who underwent curative resection were enrolled. The optimal cutoff values of the inflammatory markers were calculated using receiver operating characteristic (ROC) curve analysis, and used to divide patients into two groups whose differences were compared by Kaplan–Meier analysis. Cox univariate and multivariate analyses were used to analyze the independent prognostic inflammatory markers. The χ2 test was chosen to determine the relationship between independent prognostic inflammatory markers and clinicopathological features. We created combined scoring models and evaluated them by Cox univariate and multivariate methods. The concordance index (C-index), Akaike information criterion (AIC) and likelihood ratio were calculated to compare the models. The selected optimal inflammatory markers and their combinations were tested in different stages of HCC by Kaplan–Meier analysis. The ALR and GPR were independent prognostic factors for disease-free survival (DFS); the ALR, PLR, and GPR were independent prognostic factors for overall survival (OS). The proposed GPR and ALR-GPR-PLR score models were independent predictors for DFS and OS, respectively. The preoperative GPR and ALR-GPR-PLR score models were independent predictors for DFS and OS, respectively, and performed well in stratifying patients with HCC. The higher the score in the model was, the worse the prognosis. The online version contains supplementary material available at 10.1186/s12935-021-02204-3.
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