| Yunpeng Hua,Fei Ji,Shunjun Fu,Shunli Shen,Shaoqiang Li,Lijian Liang,Baogang Peng. The preoperative neutrophil-to-lymphocyte ratio predicts the outcomes of patients with hepatocellular carcinoma and cirrhosis after hepatectomy. Oncol Transl Med, 2015, 1: 249-255. |
| 中性粒细胞/淋巴细胞比值在肝硬化肝细胞癌患者术后预后评估中的作用 |
| The preoperative neutrophil-to-lymphocyte ratio predicts the outcomes of patients with hepatocellular carcinoma and cirrhosis after hepatectomy |
| Received:September 01, 2015 Revised:November 24, 2015 |
| DOI：10.1007/s10330-015-0117-5 |
| 中文关键词: 肝细胞癌；中性粒细胞/淋巴细胞比值；病理学，预后 |
| 英文关键词: hepatocellular cancer (HCC); neutrophil-to-lymphocyte ratio (NLR); pathology; prognosis |
| 基金项目:国家自然科学基金（81201918）；广东省科技计划项目（2012B031800099）；教育部新教师基金项目（No. 200805581172）；教育部留学回国人员科研启动基金 (教外司留[2015]311号) |
| Author Name | Affiliation | E-mail | | Yunpeng Hua | Department of Hepatic Surgery, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510080, China | hyp0427@163.com | | Fei Ji | Department of Organ Transplant Center,The First Affiliated Hospital of Sun Yat-sen University,Guangzhou 510080, China | hyp0427@163.com | | Shunjun Fu | Department of Organ Transplant Center,The First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510080, China | hyp0427@163.com | | Shunli Shen | Department of Hepatic Surgery, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510080, China | hyp0427@163.com | | Shaoqiang Li | Department of Hepatic Surgery,The First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510080, China | hyp0427@163.com | | Lijian Liang | Department of Hepatic Surgery, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510080, China | hyp0427@163.com | | Baogang Peng* | Department of hepatic Surgery, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510080, China | pengbaogang@medmail.com.cn |
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| 中文摘要: |
| 目的 探讨中性粒细胞/淋巴细胞比值（neutrophil-to- lymphocyte ratio，NLR）与肝硬化肝癌患者切除术后预后的关系。方法 回顾性分析经病理确诊为肝癌并行肝癌根治切除术的321例患者的临床资料。根据术前1周内化验结果计算NLR值，并通过受试者工作特征曲线(ROC)计算出高低NLR分组的界值。采用Kaplan-Meier生存曲线和Cox比例风险模型研究NLR对肝癌，尤其是肝硬化肝癌预后的影响。结果 NLR 与AFP(x2=5.876, P=0.015)、肿瘤大小（x2=32.046, P < 0.001）、PVTT（x2=4.930, P=0.026）、包膜完整性（x2=7.243, P=0.007）、复发率（x2=7.717, P=0.005）相关。单因素及多因素分析显示肿瘤数量、PVTT、肿瘤大小和NLR值是肝癌患者无瘤生存时间和总体生存时间的独立预后因素。术前高NLR提示着肝癌患者较差的预后，特别对于肝硬化肝癌患者更加敏感。结论 作为一项简便、有效的肝癌独立预后指标，术前NLR对于肝硬化肝癌患者的预后状况能提供更精确的判断。 |
| 英文摘要: |
| Objective: The aim of the study was to investigate the prognostic value of the preoperative peripheral neutrophil-to-lymphocyte ratio (NLR) in patients with hepatocellular cancer (HCC) and cirrhosis after hepatectomy.
Methods: This retrospective study included 321 patients with HCC who underwent resection. The NLR was calculated using the neutrophil and lymphocyte counts in routine preoperative blood tests. Receiver operating characteristic curve analysis was performed to select the most appropriate NLR cutoff value. The preoperative NLR, patient demographics, and clinical and pathological data, including disease-free survival (DFS) and overall survival (OS), were analyzed.
Results: The NLR was correlated with alpha-fetoprotein levels (χ2 = 5.876, P = 0.015), tumor size (χ2 = 32.046, P < 0.001), portal vein tumor thrombus (PVTT; χ2 = 4.930, P = 0.026), tumor encapsulation (χ2 = 7.243, P = 0.007), and recurrence (χ2 = 7.717, P = 0.005). Multivariate analyses illustrated that the number of tumors, PVTT, tumor size, and the NLR were independent factors for predicting DFS and OS. In patients with HCC and cirrhosis, but not among those without cirrhosis, a larger NLR predicted poorer postoperative DFS and OS (both P < 0.001).
Conclusion: As a simple, effective independent predictor for patients with HCC, the preoperative NLR plays an important role in accurately predicting the postoperative outcomes of patients with HCC and cirrhosis, but not those of patients without cirrhosis. |
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