Guang-Qin Xiao, Chang Liu, Da-Li Liu, Jia-Yin Yang, Lu-Nan Yan, Department of Liver and Vascular Surgery, West China Hospital of Sichuan University, Chengdu 610041, Sichuan Province, China.
World J Gastroenterol. 2013 Dec 7;19(45):8398-407. doi: 10.3748/wjg.v19.i45.8398.
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.
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.
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.
A preoperative elevated NLR significantly increased the risk for tumor recurrence in HCC patients after LT.
确定中性粒细胞与淋巴细胞比值（NLR）升高是否与乙型肝炎病毒（HBV）相关肝细胞癌（HCC）患者肝移植（LT）后肿瘤复发呈负相关，并确定最佳预测 NLR 截断值。
来自中国肝移植注册数据库的 HCC 患者 LT 数据。我们收集了我院 326 例肝癌患者的资料，将患者分为 NLR（3、4 或 5）组。然后比较这些组的临床病理数据和长期生存情况。同时，我们使用受试者工作特征（ROC）分析来确定最佳 NLR 截断值。
本研究纳入的 280 例 HCC 患者中，263 例 HBV 阳性。NLR<3 组与 NLR≥3 但<4 组患者的总生存（OS）（P=0.212）或无病生存（DFS）（P=0.601）无显著差异。NLR≥4 但<5 组与 NLR≥5 组患者的 OS（P=0.208）或 DFS（P=0.618）也无显著差异。NLR<4 组患者的 1、3 和 5 年 OS 率分别为 87.8%、63.8%和 61.5%，NLR≥4 组患者的 1、3 和 5 年 OS 率分别为 73.9%、36.7%和 30.3%（P<0.001）。NLR<4 组患者的 1、3 和 5 年 DFS 率分别为 83.9%、62.9%和 60.7%，NLR≥4 组患者的 1、3 和 5 年 DFS 率分别为 64.9%、30.1%和 30.1%（P<0.001）。单因素和多因素分析表明，包括 NLR≥4（P=0.002）在内的三个因素是 HCC 患者 LT 后肿瘤复发的显著预测因素。
术前 NLR 升高显著增加 HCC 患者 LT 后肿瘤复发的风险。
