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炎症标志物作为接受经动脉化疗栓塞的肝细胞癌患者生存的预后因素

Inflammatory Markers as Prognostic Factors of Survival in Patients Affected by Hepatocellular Carcinoma Undergoing Transarterial Chemoembolization.

作者信息

Rebonato A, Graziosi L, Maiettini D, Marino E, De Angelis V, Brunese L, Mosca S, Metro G, Rossi M, Orgera G, Scialpi M, Donini A

机构信息

Department of Radiology, University of Perugia, Perugia, Italy.

Department of General and Emergency Surgery, University of Perugia, Perugia, Italy.

出版信息

Gastroenterol Res Pract. 2017;2017:4164130. doi: 10.1155/2017/4164130. Epub 2017 Aug 15.

Abstract

INTRODUCTION

Transarterial chemoembolization (TACE) is a good choice for hepatocellular carcinoma (HCC) treatment when surgery and liver transplantation are not feasible. Few studies reported the value of prognostic factors influencing survival after chemoembolization. In this study, we evaluated whether preoperative inflammatory factors such as neutrophil to lymphocyte ratio and platelet to lymphocyte ratio affected our patient survival when affected by hepatocellular carcinoma.

METHODS

We retrospectively evaluated a total of 72 patients with hepatocellular carcinoma that underwent TACE. We enrolled patients with different etiopathogeneses of hepatitis and histologically proven HCC not suitable for surgery. The overall study population was dichotomized in two groups according to the median NLR value and was analyzed also according to other prognostic factors.

RESULTS

The global median overall survival (OS) was 28 months. The OS in patients with high NLR was statistically significantly shorter than that in patients with low NLR. The following pretreatment variables were significantly associated with the OS in univariate analyses: age, Child-Pugh score, BCLC stage, INR, and NLR. Pretreated high NLR was an independently unfavorable factor for OS.

CONCLUSION

NLR could be considered a good prognostic factor of survival useful to stratify patients that could benefit from TACE treatment.

摘要

引言

当手术和肝移植不可行时,经动脉化疗栓塞术(TACE)是治疗肝细胞癌(HCC)的一个不错选择。很少有研究报道影响化疗栓塞术后生存的预后因素的价值。在本研究中,我们评估了术前炎症因子,如中性粒细胞与淋巴细胞比值和血小板与淋巴细胞比值,在肝细胞癌患者中是否会影响患者的生存。

方法

我们回顾性评估了总共72例行TACE的肝细胞癌患者。我们纳入了患有不同病因肝炎且经组织学证实为不适于手术的HCC患者。根据中性粒细胞与淋巴细胞比值的中位数将整个研究人群分为两组,并根据其他预后因素进行分析。

结果

总体中位总生存期(OS)为28个月。高中性粒细胞与淋巴细胞比值患者的OS在统计学上显著短于低中性粒细胞与淋巴细胞比值患者。在单因素分析中,以下预处理变量与OS显著相关:年龄、Child-Pugh评分、BCLC分期、国际标准化比值(INR)和中性粒细胞与淋巴细胞比值。预处理时高中性粒细胞与淋巴细胞比值是OS的一个独立不利因素。

结论

中性粒细胞与淋巴细胞比值可被视为一个良好生存预后因素,有助于对可能从TACE治疗中获益的患者进行分层。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b1f4/5574298/da2dcf20876e/GRP2017-4164130.001.jpg

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