全身炎症反应是HIV感染的肝细胞癌患者的一个预后标志物。
Systemic Inflammatory Response Is a Prognostic Marker in HIV-Infected Patients with Hepatocellular Carcinoma.
作者信息
Pinato David J, Merli Marco, Dalla Pria Alessia, Jamshaid Shiraz, Parker Kizzy, Pagani Nicole, Hasson Hamid, Uberti Foppa Caterina, Messina Emanuela, Sharma Rohini, Nelson Mark, Bower Mark
机构信息
Department of Surgery and Cancer, Hammersmith Campus of Imperial College London, London, UK.
出版信息
Oncology. 2017;93(6):395-400. doi: 10.1159/000479521. Epub 2017 Sep 16.
BACKGROUND
Hepatocellular carcinoma (HCC) is increasingly prevalent in people living with HIV. Systemic inflammation is a prognostic factor requiring validation in HIV-associated HCC.
AIMS
Using a multi-centre database of consecutive HCC cases, we investigated the prognostic role of a panel of inflammatory markers, including neutrophil to lymphocyte ratio (NLR), using univariate and multivariate survival analyses.
RESULTS
Fifty-nine patients with HIV-associated HCC secondary to hepatitis C (69%) or B virus infection (32%) were identified. The median survival was 22 months. A raised NLR independently predicted patients' survival and was correlated with advanced Barcelona Clinic Liver Cancer stage (p = 0.003) and poor performance status (p < 0.001) but not with HIV RNA or CD4 counts.
CONCLUSION
Systemic inflammation, as measured by NLR, is a prognostic determinant associated with adverse pathological features of malignancy, but not coexisting HIV infection, suggesting a tumour-promoting role of the innate immune response that warrants further investigation in mechanistic studies.
背景
肝细胞癌（HCC）在HIV感染者中日益普遍。全身炎症是一个预后因素，需要在HIV相关HCC中进行验证。
目的
利用一个连续HCC病例的多中心数据库，我们使用单变量和多变量生存分析研究了一组炎症标志物的预后作用，包括中性粒细胞与淋巴细胞比率（NLR）。
结果
共识别出59例继发于丙型肝炎（69%）或B病毒感染（32%）的HIV相关HCC患者。中位生存期为22个月。升高的NLR独立预测患者的生存，并与巴塞罗那临床肝癌晚期（p = 0.003）和较差的体能状态（p < 0.001）相关，但与HIV RNA或CD4计数无关。
结论
以NLR衡量的全身炎症是一种与恶性肿瘤不良病理特征相关的预后决定因素，但与并存的HIV感染无关，提示固有免疫反应具有促进肿瘤的作用，这值得在机制研究中进一步探讨。
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