Yang Yun, Wang Meng-Chao, Tian Tao, Huang Jian, Yuan Sheng-Xian, Liu Lei, Zhu Peng, Gu Fang-Ming, Fu Si-Yuan, Jiang Bei-Ge, Liu Fu-Chen, Pan Ze-Ya, Zhou Wei-Ping
Eastern Hepatobiliary Surgery Hospital, Shanghai, China.
Front Oncol. 2020 Oct 16;10:576205. doi: 10.3389/fonc.2020.576205. eCollection 2020.
To evaluate the importance of preoperative blood platelet to lymphocyte ratio (PLR) in patients with hepatitis B virus (HBV)-related hepatocellular carcinoma (HCC) after liver surgery and to examine the connection with CD8 lymph cell infiltration. Between 2009 and 2014, consecutive HCC patients who received curative liver surgery were included into this retrospective study. Baseline clinicopathological characteristics were analyzed to identify predictors of recurrence-free and overall patient survival rate after liver resection. The samples of all patients were under Tissue Microarray (TMA) construction and immunohistochemical staining for CD8+.The association of the number of CD8+T-cells in the cancer nests and peritumoral stroma with PLR level was analyzed. A total of 1,174 HBV-related HCC patients who received a liver resection without any peri-operative adjuvant therapy were enrolled into this retrospective study. Univariate and Multivariate analysis using Cox regression model showed that PLR was an independent factor affecting recurrence and overall survivals. The optimal cutoff of PLR using the receiver operating characteristic curve was 150. There were 236 patients (20.1%) who had a PLR of 150 or more. The 5-year survival rate after liver resection was 71.8% in patients with a PLR of < 150 and it was 57.2% in those with a PLR of 150 or more ( < 0.001). Both 5-year recurrence-free and overall survival rates in liver cancer stage A patients at Barcelona Clinic with different PLR group were also significantly different ( = 0.007 for recurrence and = 0.001 for overall survival). Similar results were also observed in stage B patients ( < 0.001 for recurrence and = 0.033 for overall survival). To determine the association between PLR and the severity of liver inflammation, an immuno-histological examination using CD8 staining was performed on the liver specimens of 1,174 patients. Compared with low PLR (<150) group, more CD8T-cells were found in the peritumoral tissue in high PLR (≥ 150) group. PLR played as an independent factor for predicting the survival after hepatectomy for HCC patients. A high PLR was associated with an accumulation of CD8 T-cells in the peritumoral stroma.
评估术前血小板与淋巴细胞比值（PLR）在乙型肝炎病毒（HBV）相关肝细胞癌（HCC）患者肝切除术后的重要性，并探讨其与CD8淋巴细胞浸润的关系。2009年至2014年期间，将接受根治性肝手术的连续性HCC患者纳入这项回顾性研究。分析基线临床病理特征，以确定肝切除术后无复发生存率和总生存率的预测因素。对所有患者的样本进行组织微阵列（TMA）构建和CD8 +免疫组织化学染色。分析癌巢和瘤周基质中CD8 + T细胞数量与PLR水平的相关性。共有1174例接受肝切除且未进行任何围手术期辅助治疗的HBV相关HCC患者纳入这项回顾性研究。使用Cox回归模型进行单因素和多因素分析表明，PLR是影响复发和总生存的独立因素。使用受试者工作特征曲线确定的PLR最佳临界值为150。有236例患者（20.1%）的PLR为150或更高。PLR < 150的患者肝切除术后5年生存率为71.8%，而PLR为150或更高的患者为57.2%（P < 0.001）。巴塞罗那临床肝癌分期A期患者不同PLR组的5年无复发生存率和总生存率也有显著差异（复发P = 0.007，总生存P = 0.001）。B期患者也观察到类似结果（复发P < 0.001，总生存P = 0.033）。为了确定PLR与肝脏炎症严重程度之间的关联，对1174例患者的肝脏标本进行了使用CD8染色的免疫组织学检查。与低PLR（<150）组相比，高PLR（≥150）组的瘤周组织中发现更多的CD8 T细胞。PLR是预测HCC患者肝切除术后生存的独立因素。高PLR与瘤周基质中CD8 T细胞的积聚有关。
