Neutrophil-to-lymphocyte ratio acts as a prognostic factor for patients with advanced hepatocellular carcinoma
Neutrophil-to-lymphocyte ratio acts as a prognostic factor for patients with advanced hepatocellular carcinoma
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中性粒细胞与淋巴细胞比率作为晚期肝细胞癌患者的预后因素
DOI：
10.1007/s13277-014-2360-8
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发表时间：
2014-11-01
期刊：
影响因子：
--
通讯作者：
Wen, Jin-Yun
中科院分区：
文献类型：
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作者：
Li, Xing;Chen, Zhan-Hong;Wen, Jin-Yun
很少有研究调查晚期肝细胞癌（aHCC）患者的预后。本研究旨在确定aHCC患者的血细胞分类计数（包括白细胞、中性粒细胞、淋巴细胞、中性粒细胞-淋巴细胞比率（NLR）和血小板）的预后价值。回顾性分析了总共 205 名接受非系统性索拉非尼治疗的华裔 aHCC 患者。血细胞分类计数和 NLR 对总生存期 (OS) 的预后价值是通过使用多元 Cox 回归的向后消除模型整合到意大利肝癌计划 (CLIP) 评分系统中来确定的。结果，NLR 被证实是 OS 的独立预测因子 (p = 0.001)，其余参数呈现阴性结果。然后，根据 NLR 值千分之一货币符号 2.43 或 > 2.43，将 aHCC 患者分为两组。与高 NLR 水平的患者相比，低 NLR 患者的 CLIP 评分较低，6 个月生存率较高（56.1% vs 25.9%）。此外，低NLR水平与有利的预后因素相关，例如较低的甲胎蛋白、碱性磷酸酶和总胆红素，以及腹水、门静脉血栓和转移的发生率降低。此外，低NLR水平与白细胞和中性粒细胞较少以及淋巴细胞较多有关。总之，本研究首先将 NLR 确定为未接受系统性索拉非尼治疗的 aHCC 患者的独立预后因素。
Few studies investigated the prognosis of patients with advanced hepatocellular carcinoma (aHCC). This study was aimed to determine the prognostic value of differential blood cell counts including blood white cells, neutrophil, lymphocyte, neutrophil-lymphocyte ratio (NLR), and platelet in patients with aHCC. A total of 205 ethnic Chinese aHCC patients receiving non-systematic sorafenib were analyzed retrospectively. The prognostic value of differential blood cell counts and NLR for overall survival (OS) was determined by integration into Cancer of the Liver Italian Program (CLIP) score system using backward elimination model of multivariate Cox regression. As a result, NLR was confirmed to be an independent predictor for OS (p = 0.001) with the rest parameters presented negative results. Then, aHCC patients were dichotomized into two groups according to NLR values a parts per thousand currency sign2.43 or > 2.43. Patients with low NLR presented lower CLIP score and higher 6-month survival rate (56.1 vs 25.9 %) compared with patients with high NLR level. Besides, low NLR level was associated with favorable prognostic factors such as lower alpha-fetoprotein, alkaline phosphatase, and total bilirubin, as well as decreased incidence of ascites, portal vein thrombosis, and metastasis. Besides, low NLR level was associated less white cells and neutrophil granulocytes, as well as more lymphocyte. In summary, the present study firstly indentified NLR as an independent prognostic factor in aHCC patients receiving no systematic sorafenib.