术前中性粒细胞与淋巴细胞比值作为肝细胞癌减瘤手术联合经皮孤立肝灌注术后生存预测指标的回顾性分析
Preoperative neutrophil-to-lymphocyte ratio as a predictor of survival after reductive surgery plus percutaneous isolated hepatic perfusion for hepatocellular carcinoma: a retrospective analysis.
作者信息
Arai Keisuke, Fukumoto Takumi, Kido Masahiro, Tanaka Motofumi, Kuramitsu Kaori, Kinoshita Hisoka, Komatsu Shohei, Tsugawa Daisuke, Terai Sachio, Matsumoto Taku, Goto Tadahiro, Asari Sadaki, Toyama Hirochika, Ajiki Tetsuo, Ku Yonson
机构信息
Division of Hepato-Biliary-Pancreatic Surgery, Department of Surgery, Graduate School of Medicine, Kobe University, 7-5-2, Kusunoki-cho, Chuo-ku, Kobe City, Hyogo, 650-0017, Japan.
出版信息
Surg Today. 2017 Mar;47(3):385-392. doi: 10.1007/s00595-016-1384-7. Epub 2016 Jul 27.
PURPOSE
We assessed the predictive value of the preoperative neutrophil-to-lymphocyte ratio (NLR) in patients who underwent a two-stage treatment combining reductive surgery and percutaneous isolated hepatic perfusion for multiple hepatocellular carcinoma (HCC) with portal vein tumor thrombus (PVTT).
METHODS
Forty-two patients underwent the two-stage treatment between January 2000 and December 2014 at Kobe University Hospital (Hyogo, Japan). The NLR was calculated from lymphocyte and neutrophil counts in the preoperative routine blood test. Clinical data and overall survival were compared statistically and multivariate analysis was done to identify prognostic factors.
RESULTS
The median survival of patients with a preoperative NLR > 2.3 was 14.9 months (n = 13), whereas that of patients with a preoperative NLR ≤ 2.3 was 26.1 months (n = 29; P = 0.022). A preoperative NLR > 2.3 was an independent prognostic factor in patients with multiple HCC with PVTT [hazard ratio (HR) 2.329; 95 % confidence interval (CI) 1.058-5.667; P = 0.036].
CONCLUSION
Based on the results of this study, an elevated preoperative NLR is an independent predictive risk factor for patients undergoing two-stage treatment for multiple HCC with PVTT.
目的
我们评估了术前中性粒细胞与淋巴细胞比值（NLR）对接受两阶段治疗（包括肝切除术和经皮肝隔离灌注术）的多灶性肝细胞癌（HCC）合并门静脉癌栓（PVTT）患者的预测价值。
方法
2000年1月至2014年12月期间，42例患者在日本兵库县神户大学医院接受了两阶段治疗。术前常规血液检查中的淋巴细胞和中性粒细胞计数用于计算NLR。对临床数据和总生存期进行统计学比较，并进行多因素分析以确定预后因素。
结果
术前NLR>2.3的患者中位生存期为14.9个月（n = 13），而术前NLR≤2.3的患者中位生存期为26.1个月（n = 29；P = 0.022）。术前NLR>2.3是多灶性HCC合并PVTT患者的独立预后因素[风险比（HR）2.329；95%置信区间（CI）1.058 - 5.667；P = 0.036]。
结论
基于本研究结果，术前NLR升高是接受两阶段治疗的多灶性HCC合并PVTT患者的独立预测风险因素。
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