Prognostic significance of preoperative aspartate aminotransferase to neutrophil ratio index in patients with hepatocellular carcinoma after hepatic resection.
Prognostic significance of preoperative aspartate aminotransferase to neutrophil ratio index in patients with hepatocellular carcinoma after hepatic resection.
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术前门冬氨酸转氨酶与中性粒细胞比值指数对肝细胞癌肝切除术后患者预后的意义
DOI：
10.18632/oncotarget.10848
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发表时间：
2016-11-01
期刊：
影响因子：
--
通讯作者：
Peng B
中科院分区：
文献类型：
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作者：
Ji F;Fu S;Guo Z;Pang H;Chen D;Wang X;Ju W;Wang D;He X;Hua Y;Peng B
目的肝细胞癌（HCC）患者预后不良与多种炎症因子相关，中性粒细胞在其中发挥重要作用。然而，很少有研究阐明术前天冬氨酸转氨酶（AST）与中性粒细胞比率指数（ANRI）与肝癌预后不良的关系。我们的目的是阐明ANRI的预后价值，并评估不同的炎症为基础的预后评分，如ANRI，AST与淋巴细胞比率指数（ALRI），AST与血小板计数比率指数（APRI），嗜中性粒细胞-淋巴细胞比率指数（NLR），血小板-淋巴细胞比率指数（PLR）的能力。方法回顾性分析303例肝癌根治性切除术患者的临床资料。分析术前ANRI、ALRI、APRI、NLR、PLR及临床病理指标。采用单因素、多因素和Kaplan-Meier分析方法，分析上述因素对无病生存期（DFS）和总生存期（OS）的预测价值。结果ANRI与HBsAg、AST、肝硬化、肿瘤大小、PVTT、CLIP评分、复发相关。单因素分析显示ANRI、ALRI、APRI、NLR、PLR与肝癌根治性切除患者的DFS和OS显著相关。多因素分析显示ANRI上级于ALRI、APRI、NLR、PLR，与DFS和OS独立相关。生存分析显示术前ANRI > 7.8预示肝癌切除术后预后不良。术前ANRI对不同亚组HCC的预后价值也不同。此外，ANRI和NLR的组合扩大了预测范围。结论术前ANRI是HCC患者预后的独立有效预测指标，ANRI水平越高，预后越差，ANRI与NLR联合检测可提高预后的准确性。
Objectives Various inflammation-based prognostic scores have been associated with poor survival in patients with hepatocellular carcinoma (HCC), and neutrophils display important roles. However, few studies have illuminated the relationship between preoperative aspartate aminotransferase (AST) to neutrophil ratio index (ANRI) and poor prognosis of HCC. We aimed to clarify the prognostic value of ANRI and evaluate the ability of different inflammation-based prognostic scores such as ANRI, AST to lymphocyte ratio index (ALRI), AST to platelet count ratio index (APRI), neutrophil-lymphocyte ratio index (NLR), and platelet-lymphocyte ratio index (PLR). Methods Data were collected retrospectively from 303 patients who underwent curative resection for HCC. Preoperative ANRI, ALRI, APRI, NLR, PLR and clinico-pathological variables were analyzed. Univariate, multivariate and Kaplan-Meier analyses were performed to identify the predictive value of the above factors for disease-free survival (DFS) and overall survival (OS). Results ANRI was correlated with presence of HBsAg, AST, presence of cirrhosis, tumor size, PVTT, cancer of the liver Italian program (CLIP) score, recurrence. Univariate analysis showed ANRI, ALRI, APRI, NLR, PLR were significantly associated with DFS and OS in HCC patients with curative resection. After multivariate analysis, ANRI was demonstrated to be superior to ALRI, APRI, NLR, PLR, which were independently correlated with DFS and OS. Survival analysis showed that preoperative ANRI > 7.8 predicted poor prognosis of patients with HCC after hepatectomy. preoperative ANRI also showed different prognostic value in various subgroups of HCC. Furthermore, the predictive range was expanded by the combination of ANRI and NLR. Conclusions preoperative ANRI is an independent effective predictor of prognosis for patients with HCC, higher levels of ANRI predict poorer outcomes and the combining ANRI and NLR increases the prognostic accuracy of testing.