Department of Hepatobiliary Surgery, the First Affiliated Hospital, Sun Yat-sen University, No, 58 Zhongshan Er Road, Guangzhou 510080, China.
BMC Cancer. 2014 Feb 21;14:117. doi: 10.1186/1471-2407-14-117.
Neutrophil-lymphocyte ratio (NLR) has recently been reported as a predictor of Hepatocellular carcinoma (HCC). However, its prognostic value in HCC still remains controversial. In this study, we aimed to evaluate the association between NLR and clinical outcome of HCC patients by performing meta-analysis.
A comprehensive literature search for relevant studies published up to August 2013 was performed by using PubMed, Ovid, the Cochrane Library and Web of Science databases. Meta-analysis was performed using hazard ratio (HR) or odds ratio (OR) and 95% confidence intervals (95% CIs) as effect measures.
A total of 15 studies encompassing 3094 patients were included in this meta-analysis. Our pooled results showed that high NLR was associated with poor overall survival (OS) and disease free survival (DFS) in HCC initially treated by liver transplantation (HR = 3.42, 95% CI:2.41-4.85,P = 0.000; HR = 5.90, 95% CI:3.99-8.70,P = 0.000, respectively) and surgical resection (HR = 3.33, 95% CI:2.23-4.98, P = 0.000; HR = 2.10, 95% CI: 2.06-2.14, respectively). High NLR was also associated with poor OS in HCC treated by radiofrequency-ablation (HR = 1.28, 95%CI: 1.10-1.48, P = 0.000), TACE (HR = 2.52, 95% CI: 1.64-3.86, P = 0.000) and mixed treatment (HR = 1.85, 95% CI: 1.40-2.44, P = 0.000), respectively. In addition, high NLR was significantly correlated with the presence of vascular invasion (OR = 2.69, 95% CI: 2.01-3.59, P = 0.000), tumor multifocality (OR = 1.74, 95% CI: 1.30-2.34, P = 0.000) and higher incidence of AFP ≥ 400 ng/ml (OR = 1.46, 95% CI: 1.01-2.09, P = 0.04).
Elevated NLR indicates a poor prognosis for patients with HCC. NLR may be a convenient, easily-obtained, low cost and reliable biomarker with prognostic potential for HCC.
中性粒细胞与淋巴细胞比值（NLR）最近被报道为肝细胞癌（HCC）的预测因子。然而，其在 HCC 中的预后价值仍存在争议。本研究旨在通过荟萃分析评估 NLR 与 HCC 患者临床结局之间的相关性。
使用 PubMed、Ovid、Cochrane 图书馆和 Web of Science 数据库，对截至 2013 年 8 月发表的相关研究进行全面的文献检索。使用风险比（HR）或优势比（OR）和 95%置信区间（95%CI）作为效应测量值进行荟萃分析。
本荟萃分析共纳入了 15 项研究，共 3094 例患者。我们的汇总结果表明，在接受肝移植（HR=3.42，95%CI：2.41-4.85，P=0.000；HR=5.90，95%CI：3.99-8.70，P=0.000）和手术切除（HR=3.33，95%CI：2.23-4.98，P=0.000；HR=2.10，95%CI：2.06-2.14）治疗的 HCC 患者中，高 NLR 与总生存（OS）和无病生存（DFS）不良相关。高 NLR 也与射频消融（HR=1.28，95%CI：1.10-1.48，P=0.000）、TACE（HR=2.52，95%CI：1.64-3.86，P=0.000）和混合治疗（HR=1.85，95%CI：1.40-2.44，P=0.000）治疗的 HCC 患者的 OS 不良相关。此外，高 NLR 与血管侵犯（OR=2.69，95%CI：2.01-3.59，P=0.000）、肿瘤多发性（OR=1.74，95%CI：1.30-2.34，P=0.000）和 AFP≥400ng/ml 的发生率较高（OR=1.46，95%CI：1.01-2.09，P=0.04）显著相关。
升高的 NLR 表明 HCC 患者预后不良。NLR 可能是一种方便、易得、低成本且可靠的具有 HCC 预后潜力的生物标志物。
