Inflammatory Markers are Associated with Outcome in Patients with Unresectable Hepatocellular Carcinoma Undergoing Transarterial Chemoembolization
Inflammatory Markers are Associated with Outcome in Patients with Unresectable Hepatocellular Carcinoma Undergoing Transarterial Chemoembolization
复制标题
DOI：
10.1245/s10434-012-2639-1
复制
发表时间：
2013-03-01
影响因子：
3.7
通讯作者：
Schmidt, Carl R.
中科院分区：
文献类型：
--
作者：
McNally, Megan E.;Martinez, Antonio;Schmidt, Carl R.
血清嗜中性粒细胞-淋巴细胞比率（NLR）与包括肝细胞癌（HCC）在内的几种实体器官癌的预后相关。我们回顾了我们在接受经动脉化疗栓塞（TACE）作为初始治疗的HCC患者中的经验。采用血清全血细胞计数计算TACE前后的NLR。Kaplan-Meier方法用于确定生存率，并通过对数秩检验确定组间差异。中位年龄为60.5岁。中位总生存期为12.6（95%置信区间8.3-17）个月。术前NLR高的患者的中位生存期为4.2个月，而NLR正常的患者为15个月（p = 0.021）。在治疗后1个月NLR升高或保持升高的患者中，与正常化或保持正常的患者相比，生存率更差（18.6 vs. 10.6个月，p = 0.026）。6个月时也是如此（21.3 vs. 9.5个月，p = 0.002）。无反应的NLR与非常差的结局相关（中位生存期3.7个月）。临床病理因素的多因素分析显示，肝外病变和高NLR是与生存率差相关的独立因素。我们的研究表明，围手术期血清NLR趋势与接受TACE的不可切除HCC的结局相关。血清NLR很容易从常规全血细胞分类计数中计算出来。沿着肝功能，血清NLR可能有助于临床医生提供预后信息和监测对治疗的反应。
The serum neutrophil-lymphocyte ratio (NLR) is associated with outcomes in several solid organ cancers, including hepatocellular carcinoma (HCC).We reviewed our experience in patients with HCC who underwent transarterial chemoembolization (TACE) as the initial treatment. Serum complete blood counts were used to calculate the NLR before and after TACE. The Kaplan-Meier method was used to determine survival and significant differences between groups by the log-rank test.There were 103 patients identified who underwent TACE for HCC. The median age was 60.5 years. Median overall survival was 12.6 (95 % confidence interval 8.3-17) months. Median survival in patients with a high preprocedural NLR was 4.2 months compared to 15 months in those with a normal NLR (p = 0.021). In those whose NLR either rose 1 month after treatment or remained elevated, survival was worse compared to those who normalized or remained normal (18.6 vs. 10.6 months, p = 0.026). The same was true at 6 months (21.3 vs. 9.5 months, p = 0.002). An unresponsive NLR was associated with very poor outcome (median survival 3.7 months). Multivariate analysis of clinicopathologic factors showed that presence of extrahepatic disease and high NLR were independent factors associated with worse survival.Our study demonstrates that periprocedural trends of serum NLR are associated with outcome in unresectable HCC undergoing TACE. Serum NLR is easy to calculate from a routine complete blood count with differential. Along with liver function, serum NLR may be helpful to clinicians in providing prognostic information and monitoring response to therapy.