Prognostic value of preoperative peripheral blood monocyte count in patients with hepatocellular carcinoma
Prognostic value of preoperative peripheral blood monocyte count in patients with hepatocellular carcinoma
复制标题
DOI：
10.1016/j.surg.2005.10.009
复制
发表时间：
2006-06-01
期刊：
影响因子：
3.8
通讯作者：
Kitano, Seigo
中科院分区：
文献类型：
--
作者：
Sasaki, Atsushi;Iwashita, Yukio;Kitano, Seigo
背景外周血白细胞亚群与肝癌预后的关系尚未见报道。我们试图阐明术前外周血白细胞亚群计数，特别是单核细胞绝对计数对肝切除后肝癌患者的预后价值。我们回顾性研究了198例接受根治性切除术的肝癌患者术前外周血单核细胞绝对数量与临床病理因素或长期预后之间的关系。单因素分析显示，外周血单核细胞计数> 300/mm 2的患者5年无病生存率显著降低（3）（14.8%）比计数300/mm的患者（3）甲胎蛋白水平> 100 ng/mL，天冬氨酸转氨酶水平> 100 IU/mL，和微血管侵犯是无病生存期小于5年的独立危险因素。外周血单核细胞计数在男性患者、非炎性肝脏、微血管侵犯、肝大切除、年龄较大（> 65岁）、肿瘤较大（>= 50 mm）或血小板计数增加（> 100，000/mm 3）的患者中高于无这些特征的患者。我们的研究结果表明，术前外周血单核细胞绝对计数（> 300/mm 3）可能与肿瘤进展有关，并且是肝细胞癌切除术后复发的独立危险因素。对于术前外周血单核细胞绝对计数升高的患者，术后辅助化疗可能是必要的。
Background. The Prognostic significance of the leukocyte subsets in peripheral blood has not yet been investigated in hepatocellular carcinoma patients. We sought to clarify the Prognostic value of preoperative peripheral blood leukocyte subset counts, especially the absolute monocyte count, in HCC patients who have undergone hepatic resection.Methods. We retrospectively examined the relation between the preoperative absolute number of peripheral monocytes and clinicopathologic factors or long-term prognosis in 198 patients with hepatocellular carcinoma who underwent curative resection.Results. Univariate analysis indicated a significantly worse 5-year disease-free survival rate in patients with a peripheral blood monocyte count > 300/mm(3) (14.8%) than in patients with a count 300/mm(3) alpha-fetoprotein level > 100 ng/mL,aspartate aminotransferase level > 100 IU/mL, and presence of microvascular invasion were independent risk factors for disease-free survival of less than 5 years. The peripheral blood monocyte count was higher in patients of male sex or those with a noncirrhotic liver, microvascular invasion, major hepatic resection, older age (> 65 years), large tumor (>= 50 mm), or increased platelet count (> 100,000/mm(3)) than in patients without these characteristics.Conclusions. Our findings indicate that the preoperative absolute count (> 300/mm(3)) of peripheral blood monocytes may be related to tumor progression and that it is an independent risk factor for recurrence of hepatocellular carcinoma after resection. Postoperative adjuvant chemotherapy might be necessary in patients with elevation of the preoperative absolute count of peripheral blood monocytes.