Afshar Mehran, Fletcher Peter, Bardoli Antonio D, Ma Yuk Ting, Punia Pankaj
Oncology, St George's University Hospitals NHS Foundation Trust, London, UK.
Cancer Research UK Clinical Trials Unit, Birmingham, UK.
Oncotarget. 2018 Mar 30;9(24):16988-16995. doi: 10.18632/oncotarget.24769.
Sorafenib is the current standard of care for patients with advanced or metastatic hepatocellular carcinoma. Currently no universally agreed model exists correlating the Neutrophil Lymphocyte ratio (NLR) and non-secretion of AFP with the survival of HCC patients treated with sorafenib.
We retrospectively analysed patient records with a confirmed diagnosis of HCC treated with sorafenib between April 2009 and March 2014. Survival analysis was performed using the Kaplan-Meier method and Cox regression.
Patients separated into groups based on NLR (≤3 or >3), or AFP secretion profile (<7 ng/ml or ≥7 ng/ml) derived diverging Kaplan-Meier curves for overall survival (OS). The median OS in those with NLR ≤3.0 was 9.0 months (95% CI: 7.7-11.1 months) and in those with NLR >3.0 it was 6.0 months (95% CI: 4.9-8.2 months) [HR 1.32 (95% CI: 0.96-1.80)]. The median overall survival post sorafenib was higher in the "non-secretor" AFP group. OS for AFP <7 ng/ml was 10.0 months (95% CI: 7.7-19.3 months) compared to AFP ≥7ng/ml: 6.6 months (95% CI: 5.3-8.4 months) [HR 1.64 (95% CI: 1.15-2.33)].
NLR and AFP non - secretion at diagnosis are potential significant prognosticators for overall survival from initiation of sorafenib.
索拉非尼是晚期或转移性肝细胞癌患者当前的标准治疗药物。目前尚无普遍认可的模型来关联中性粒细胞淋巴细胞比值（NLR）和甲胎蛋白（AFP）不分泌与接受索拉非尼治疗的肝癌患者的生存率。
我们回顾性分析了2009年4月至2014年3月期间确诊为肝癌并接受索拉非尼治疗的患者记录。使用Kaplan-Meier方法和Cox回归进行生存分析。
根据NLR（≤3或>3）或AFP分泌情况（<7 ng/ml或≥7 ng/ml）分组的患者，其总生存期（OS）的Kaplan-Meier曲线不同。NLR≤3.0的患者中位总生存期为9.0个月（95%置信区间：7.7-11.1个月），NLR>3.0的患者为6.0个月（95%置信区间：4.9-8.2个月）[风险比1.32（95%置信区间：0.96-1.80）]。“AFP非分泌者”组索拉非尼治疗后的中位总生存期更高。AFP<7 ng/ml患者的总生存期为10.0个月（95%置信区间：7.7-19.3个月），而AFP≥7 ng/ml患者为6.6个月（95%置信区间：5.3-8.4个月）[风险比1.64（95%置信区间：1.15-至2.33）]。
诊断时的NLR和AFP不分泌是索拉非尼治疗开始后总生存期的潜在重要预后指标。
