Qin Li, Yang Xiao-Ling, Li Chuan, Luo Yan-Li
Department of Liver Surgery, West China Hospital, Sichuan University, Chengdu 610041, China.
Sichuan Da Xue Xue Bao Yi Xue Ban. 2018 Jul;49(4):645-648.
To investigate the value of joint score of platelet to lymphocyte ratio (PLR) and prognostic nutritional index (PNI) to predict postoperative recurrence and mortality of patients with hepatocellular carcinoma (HCC) after liver resection.
Clinical data of HCC patients within Milan criteria who underwent liver resection at our center were retrospectively reviewed (=269). The preoperative PLR and PNI of all patients were measured, and. the score of PLR+PNI was calculated. The patients with high PLR (≥150) and low PNI <45) were allocated a score of 2; while the patients had one or neither of these elevations were allocated a score of 1 or 0, respectively. Postoperative survival was estimated by Kaplan-Meier method with log-rank test. Multivariate analysis used Cox regression model.
Multivariate analysis showed microvascular invasion, high alpha-fetoprotein (AFP) level, multiple tumors and PLR+PNI score were associated with postoperative recurrence. Microvascular invasion, transfusion and PLR+PNI score were independent risks factors for overall survival. The 5-year recurrence-free survival rates for the patient with PLR+PNI score of 0, 1, 2 were 43.4%, 27.8%, and 19.9% respectively (<0.001). The 5-year overall survival rates were 84.1%, 72.3%, and 17.7% respectively (<0.001).
High PLR+PNI score seems related to high incidence of postoperative recurrence and low long-term survival in the patients with HCC after liver resection.
探讨血小板与淋巴细胞比值(PLR)和预后营养指数(PNI)的联合评分对预测肝细胞癌(HCC)患者肝切除术后复发及死亡的价值。
回顾性分析我院中心符合米兰标准并接受肝切除的HCC患者的临床资料(=269例)。测量所有患者术前的PLR和PNI,并计算PLR+PNI评分。PLR高(≥150)且PNI低(<45)的患者评分为2分;而仅有其中一项升高或两项均未升高的患者分别评分为1分或0分。采用Kaplan-Meier法及对数秩检验评估术后生存率。多因素分析采用Cox回归模型。
多因素分析显示,微血管侵犯、高甲胎蛋白(AFP)水平、多发肿瘤及PLR+PNI评分与术后复发相关。微血管侵犯、输血及PLR+PNI评分是总生存的独立危险因素。PLR+PNI评分为0、1、2分的患者5年无复发生存率分别为43.4%、27.8%和19.9%(<0.001)。5年总生存率分别为84.1%、72.3%和17.7%(<0.001)。
高PLR+PNI评分似乎与HCC患者肝切除术后高复发率及低长期生存率相关。