Yu Jeong Il, Park Hee Chul, Yoo Gyu Sang, Paik Seung Woon, Choi Moon Suk, Kim Hye-Seung, Sohn Insuk, Nam Heerim
Department of Radiation Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul 06351, Korea.
Department of Medical Device Management and Research, Samsung Advanced Institute for Health Sciences and Technology, Sungkyunkwan University, 81 Irwon-ro, Gangnam-gu, Seoul 06351, Korea.
Cancers (Basel). 2020 May 21;12(5):1300. doi: 10.3390/cancers12051300.
This study aimed to investigate the clinical significance of systemic inflammation markers (SIMs)-including neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and lymphocyte-to-monocyte ratio (LMR)-in patients with newly diagnosed, previously untreated hepatocellular carcinoma (HCC). The present study was performed using prospectively collected registry data of newly diagnosed, previously untreated HCC from a single institution. The training set included 6619 patients from 2005 to 2013 and the validation set included 2084 patients from 2014 to 2016. The SIMs as continuous variables significantly affected the overall survival (OS), and the optimal cut-off value of NLR, PLR, and LMR was 3.0, 100.0, and 3.0, respectively. There were significant correlations between SIMs and the albumin-bilirubin grade/Child-Turcotte-Pugh class (indicative of liver function status) and the staging system/portal vein invasion (indicative of the tumor burden). The OS curves were well stratified according to the prognostic model of SIMs and validated using the bootstrap method (1000 times, C-index 0.6367, 95% confidence interval (CI) 0.6274-0.6459) and validation cohort (C-index 0.6810, 95% CI 0.6570-0.7049). SIMs showed significant prognostic ability for OS, independent of liver function and tumor extent, although these factors were significantly correlated with SIMs in patients with newly diagnosed, previously untreated HCC.
本研究旨在探讨全身炎症标志物（SIMs）——包括中性粒细胞与淋巴细胞比值（NLR）、血小板与淋巴细胞比值（PLR）以及淋巴细胞与单核细胞比值（LMR）——在新诊断的、未经治疗的肝细胞癌（HCC）患者中的临床意义。本研究使用了前瞻性收集的来自单一机构的新诊断的、未经治疗的HCC登记数据。训练集包括2005年至2013年的6619例患者，验证集包括2014年至2016年的2084例患者。作为连续变量的SIMs显著影响总生存期（OS），NLR、PLR和LMR的最佳截断值分别为3.0、100.0和3.0。SIMs与白蛋白-胆红素分级/Child-Turcotte-Pugh分级（指示肝功能状态）以及分期系统/门静脉侵犯（指示肿瘤负荷）之间存在显著相关性。根据SIMs的预后模型对OS曲线进行了良好分层，并使用自助法（1000次，C指数0.6367，95%置信区间（CI）0.6274 - 0.6459）和验证队列（C指数0.6810，95%CI 0.6570 - 0.7049）进行了验证。SIMs显示出对OS具有显著的预后能力，独立于肝功能和肿瘤范围，尽管在新诊断的、未经治疗的HCC患者中，这些因素与SIMs显著相关。
