Hu Xu Guang, Mao Wei, Park Yong Keun, Xu Wei Guang, Kim Bong Wan, Wang Hee Jung
Division of Hepatobiliary Surgery and Liver Transplantation, Department of Surgery, Ajou University School of Medicine, Suwon, Korea.
Department of Surgery, International St. Mary's Hospital, Incheon, Korea.
Yonsei Med J. 2016 Sep;57(5):1115-23. doi: 10.3349/ymj.2016.57.5.1115.
The systemic inflammation biomarker, Neutrophil-to-Lymphocyte Ratio (NLR), has been reported as one of the adverse prognostic factors for hepatocellular carcinoma (HCC) patient. The purpose of this study was to evaluate whether NLR could predict the risk of recurrence and death for the HCC patient, according to Milan criteria after hepatectomy.
Retrospective analysis was performed on a database of HCC patients who underwent hepatectomy between March 2001 and December 2011. The cutoff value of NLR was decided by receiver operating characteristic (ROC) curve analysis. Univariate and multivariate regression analyses were performed to identify predictive factors of recurrence and death.
A total of 213 patients were included in the present study. The median follow-up period was 48 months. One hundred and seven patients were experienced tumor recurrence; forty of them recurred within 12 months (early recurrence). NLR ≥1.505, albumin ≤3.75 g/dL, microvascular invasion and high grade of cirrhosis were found to be independent factors for adverse recurrence-free survival in multivariate regression analysis. And NLR ≥1.945 was also found as a prognosis factor for early recurrence by univariate regression analysis.
Elevated preoperative NLR can be easily obtained and reliable biomarker for assessing the tumor recurrence and early recurrence of Milan criteria HCC after the initial hepatectomy.
全身炎症生物标志物中性粒细胞与淋巴细胞比值（NLR）已被报道为肝细胞癌（HCC）患者不良预后因素之一。本研究旨在评估根据米兰标准行肝切除术后，NLR能否预测HCC患者的复发风险和死亡风险。
对2001年3月至2011年12月期间接受肝切除术的HCC患者数据库进行回顾性分析。通过受试者工作特征（ROC）曲线分析确定NLR的临界值。进行单因素和多因素回归分析以确定复发和死亡的预测因素。
本研究共纳入213例患者。中位随访期为48个月。107例患者出现肿瘤复发；其中40例在12个月内复发（早期复发）。多因素回归分析发现，NLR≥1.505、白蛋白≤3.75g/dL、微血管侵犯和高等级肝硬化是无复发生存不良的独立因素。单因素回归分析还发现NLR≥1.945是早期复发的预后因素。
术前NLR升高是评估米兰标准HCC初次肝切除术后肿瘤复发和早期复发的易于获得且可靠的生物标志物。
