Neutrophil-lymphocyte ratio predicts the prognosis of patients with hepatocellular carcinoma after liver transplantation
Neutrophil-lymphocyte ratio predicts the prognosis of patients with hepatocellular carcinoma after liver transplantation
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中性粒细胞与淋巴细胞比值预测肝细胞癌肝移植术后患者的预后
DOI：
10.3748/wjg.v19.i45.8398
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发表时间：
2013-12-07
影响因子：
4.3
通讯作者：
Yan, Lu-Nan
中科院分区：
文献类型：
--
作者：
Xiao, Guang-Qin;Liu, Chang;Yan, Lu-Nan
目的：探讨乙型肝炎病毒（HBV）相关性肝细胞癌（HCC）患者肝移植（LT）术后中性粒细胞-淋巴细胞比率（NLR）升高是否与肿瘤复发负相关，并确定最佳预测NLR临界值。方法：肝细胞癌患者行肝移植的数据来自中国肝移植注册数据库。我们收集了在我们医疗中心接受肝移植的326例肝癌患者的数据。我们根据nlr（3,4或5）将患者分组。然后，我们比较了两组患者的临床病理数据和长期生存率。同时，我们利用接收机工作特性分析来确定最佳的NLR截止点。结果：本研究纳入的280例HCC患者中，263例HBV阳性。NLR < 3的患者与NLR bb0 = 3但< 4的患者在总生存期（OS） （P = 0.212）或无病生存期（DFS） （P = 0.601）方面无显著差异。NLR >= 4但< 5的患者与NLR >= 5的患者在OS （P = 0.208）和DFS （P = 0.618）方面也无显著差异。NLR < 4与NLR bb0 = 4患者的1、3、5年OS分别为87.8%、63.8%、61.5%与73.9%、36.7%、30.3% （P < 0.001）。NLR < 4与NLR bb0 = 4患者的1、3、5年DFS率分别为83.9%、62.9%、60.7%与64.9%、30.1%、30.1% （P < 0.001）。单因素和多因素分析显示，NLR >= 4 （P = 0.002）等3个因素是HCC患者lt后肿瘤复发的显著预测因子。结论：术前NLR升高可显著增加HCC患者lt后肿瘤复发的风险。(C) 2013百时登出版集团有限公司。版权所有。
AIM: To determine whether an elevated neutrophil-lymphocyte ratio (NLR) is negatively associated with tumor recurrence in patients with hepatitis B virus (HBV)-related hepatocellular carcinoma (HCC) after liver transplantation (LT), and to determine the optimal predictive NLR cut-off value.METHODS: The data of HCC patients who had undergone LT came from the China Liver Transplant Registry database. We collected data from 326 liver cancer patients who had undergone LT at our medical center. We divided the patients into groups based on their NLRs (3, 4 or 5). We then compared the clinicopathological data and long-time survival between these groups. Meanwhile, we used receiver operating characteristic analysis to determine the optimal NLR cut-off.RESULTS: Of 280 HCC patients included in this study, 263 were HBV positive. Patients with an NLR < 3 and patients with an NLR >= 3 but < 4 showed no significant differences in overall survival (OS) (P = 0.212) or disease-free survival (DFS) (P = 0.601). Patients with an NLR >= 4 but < 5 and patients with an NLR >= 5 also showed no significant differences in OS (P = 0.208) or DFS (P = 0.618). The 1-, 3- and 5-year OS rates of patients with an NLR < 4 vs an NLR >= 4 were 87.8%, 63.8% and 61.5% vs 73.9%, 36.7% and 30.3%, respectively (P < 0.001). The 1-, 3- and 5-year DFS rates of patients with an NLR < 4 vs NLR >= 4 were 83.9%, 62.9% and 60.7% vs 64.9%, 30.1% and 30.1%, respectively (P < 0.001). Univariate and multivariate analyses demonstrated that three factors, including NLR >= 4 (P = 0.002), were significant predictors of tumor recurrence in HCC patients after LT.CONCLUSION: A preoperative elevated NLR significantly increased the risk for tumor recurrence in HCC patients after LT. (C) 2013 Baishideng Publishing Group Co., Limited. All rights reserved.