术前血小板计数与中性粒细胞-淋巴细胞比值对肝细胞癌患者的预后意义。
Prognostic Significance of Pre-surgical Combined Platelet Count and Neutrophil-Lymphocyte Ratio for Patients With Hepatocellular Carcinoma.
机构信息
Division of Surgical Oncology, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine, Yonago, Japan.
Division of Surgical Oncology, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine, Yonago, Japan
出版信息
In Vivo. 2019 Nov-Dec;33(6):2241-2248. doi: 10.21873/invivo.11729.
BACKGROUND/AIM: Recent studies have investigated a novel inflammation-based prognostic system using the combination of platelet count and neutrophil-lymphocyte ratio (COP-NLR). As platelet count decreases with liver damage, we hypothesized that COP-NLR could indicate both inflammation and hepatic reserve in patients with hepatocellular carcinoma (HCC). This study was conducted to clarify the prognostic significance of preoperative COP-NLR in patients with HCC.
PATIENTS AND METHODS
We enrolled 176 patients with histologically-proven HCC who underwent initial curative hepatectomy. Patients were assigned one point each for low platelet count (<15×10/μl) or for high NLR (≥2.0), for hepatic-COP-NLR scores (h-COP-NLR) of 0, 1 or 2.
RESULTS
Five-year overall survival (OS) and recurrence-free survival (RFS) rates were 74.5±9%, and 62.2%±9.3% for score 0, 63.6±5.4% and 50.3%±5.6% for score 1, and 45.2±8.8% and 40.6±8.7% for score 2, respectively, and significantly differed (OS: p=0.01; RFS: p=0.03). In multivariate analysis, h-COP-NLR was an independent risk factor for tumor recurrence (HR=1.39, p=0.03) and death (HR=1.71, p=0.02).
CONCLUSION
h-COP-NLR was an independent predictor for prognosis of HCC patients after hepatic resection.
背景/目的：最近的研究使用血小板计数和中性粒细胞与淋巴细胞比值（COP-NLR）的组合，调查了一种新的炎症为基础的预后系统。由于血小板计数随肝损伤而降低，我们假设 COP-NLR 可以同时反映炎症和肝癌（HCC）患者的肝储备功能。本研究旨在阐明 HCC 患者术前 COP-NLR 的预后意义。
患者和方法
我们纳入了 176 名经组织学证实的 HCC 患者，这些患者接受了初始根治性肝切除术。患者的低血小板计数（<15×10/μl）或高 NLR（≥2.0）各记 1 分，肝 COP-NLR 评分（h-COP-NLR）为 0、1 或 2。
结果
0 分、1 分和 2 分的 5 年总生存率（OS）和无复发生存率（RFS）分别为 74.5±9%、63.6±5.4%和 50.3±5.6%、63.6±5.4%和 50.3±5.6%、45.2±8.8%和 40.6±8.7%，差异有统计学意义（OS：p=0.01；RFS：p=0.03）。多因素分析显示，h-COP-NLR 是肿瘤复发（HR=1.39，p=0.03）和死亡（HR=1.71，p=0.02）的独立危险因素。
结论
h-COP-NLR 是 HCC 患者肝切除术后预后的独立预测因子。
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