Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan.
J Gastroenterol Hepatol. 2012 Mar;27(3):553-61. doi: 10.1111/j.1440-1746.2011.06910.x.
Increasing evidence correlates the presence of systemic inflammation with poor survival in patients with hepatocellular carcinoma (HCC). We studied whether peripheral blood neutrophil-to-lymphocyte ratio (NLR), a marker of systemic inflammatory response, would be a useful predictor for outcome in patients with early HCC undergoing radiofrequency ablation (RFA).
A total of 158 patients with early HCC underwent RFA. Potential prognostic factors such as age, gender, tumoral characteristics, Child-Turcotte-Pugh (CTP) class and NLR were analyzed. The study endpoints were overall survival (OS) and new recurrence.
We modeled NLR as a continuous explanatory variable in regression analyses. Multivariate analysis revealed that tumor size (P = 0.005) and high baseline NLR (P = 0.001) were independent explanatory variables associated with unfavorable OS. Regarding new recurrence, multivariate analysis showed that CTP class B (P = 0.002), α-fetoprotein > 400 ng/mL (P = 0.030), tumor size (P = 0.002) and tumor multiplicity (P = 0.013) were found to be worse prognosticators, but not baseline NLR. In a subset analysis of 140 patients whose post-RFA NLR data at first follow-up visit were available, multivariate analysis revealed that high post-RFA NLR was identified as an independent covariate, not only for OS (P = 0.006), but for new recurrence (P = 0.010) as well.
High baseline NLR was associated with worse OS for patients with early HCC; post-RFA NLR predicted not only OS, but also tumor recurrence.
越来越多的证据表明，全身炎症的存在与肝细胞癌（HCC）患者的不良预后相关。我们研究了外周血中性粒细胞与淋巴细胞比值（NLR）作为全身炎症反应标志物是否可作为接受射频消融（RFA）治疗的早期 HCC 患者预后的有用预测指标。
共 158 例早期 HCC 患者接受 RFA 治疗。分析了年龄、性别、肿瘤特征、Child-Turcotte-Pugh（CTP）分级和 NLR 等潜在预后因素。研究终点为总生存期（OS）和新复发。
我们将 NLR 建模为回归分析中的连续解释变量。多变量分析显示，肿瘤大小（P = 0.005）和基线 NLR 升高（P = 0.001）是与 OS 不良相关的独立解释变量。关于新复发，多变量分析显示 CTP 分级 B（P = 0.002）、甲胎蛋白 > 400ng/ml（P = 0.030）、肿瘤大小（P = 0.002）和肿瘤多发（P = 0.013）是较差的预后因素，但基线 NLR 不是。在 140 例患者的亚组分析中，其在首次随访时的 post-RFA NLR 数据可用，多变量分析显示，高 post-RFA NLR 不仅是 OS（P = 0.006）的独立预测因子，也是新复发（P = 0.010）的独立预测因子。
基线 NLR 升高与早期 HCC 患者的 OS 不良相关；post-RFA NLR 不仅预测 OS，还预测肿瘤复发。
