Center of Integrative Medicine, Beijing Ditan Hospital, Capital Medical University.
Department of Hepatology, Tianjin Second People's Hospital.
Eur J Gastroenterol Hepatol. 2021 Dec 1;33(1S Suppl 1):e686-e692. doi: 10.1097/MEG.0000000000002217.
The neutrophil-to-lymphocyte ratio (NLR) has been reported as a prognostic marker of hepatocellular carcinoma (HCC); however, the relationship between NLR and risk of HCC occurrence has yet to be systematically elucidated. We aimed to investigate the association between NLR and HCC risk in patients with hepatitis B-caused cirrhosis (HBC) undergoing antiviral therapy.
A total of 1599 patients with HBC receiving entecavir or tenofovir at three tertiary hospitals between June 2014 and November 2017 were included. Cox proportional hazards regression was used to identify the association between NLR and risk of HCC occurrence by adjusting for potential risk factors. The cumulative incidence of HCC was evaluated using Kaplan-Meier analysis.
At study enrollment, the median NLR was 2.0 (interquartile range, 1.4-3.0). The 3-year cumulative probabilities of HCC were 4.8, 8.4, 13.2, and 18.0% across the NLR quartiles, respectively (P < 0.001). Compared with the lowest quartile, higher NLR correlated with an increased HCC occurrence [NLR 1.4-2.0: adjusted hazard ratio (aHR), 1.18 (95% confidence interval (CI), 1.11-1.25); NLR 2.0-3.0: aHR, 2.09 (95% CI, 1.19-3.66); NLR > 3.0: aHR, 2.80 (95% CI, 1.59-4.95); P for trend = 0.001] in the fully adjusted models. In the subgroup analysis, elevated NLR was associated with increased HCC risk, regardless of stratification criteria.
Elevated NLR is an independent risk factor for HCC occurrence in patients with HBC undergoing antiviral therapy.
中性粒细胞与淋巴细胞比值（NLR）已被报道为肝细胞癌（HCC）的预后标志物；然而，NLR 与 HCC 发生风险之间的关系尚未得到系统阐明。我们旨在研究接受抗病毒治疗的乙型肝炎相关肝硬化（HBC）患者的 NLR 与 HCC 风险之间的关系。
本研究纳入了 2014 年 6 月至 2017 年 11 月在三家三级医院接受恩替卡韦或替诺福韦治疗的 1599 例 HBC 患者。采用 Cox 比例风险回归模型，通过调整潜在的危险因素，来确定 NLR 与 HCC 发生风险之间的关系。采用 Kaplan-Meier 分析评估 HCC 的累积发生率。
在研究入组时，NLR 的中位数为 2.0（四分位距，1.4-3.0）。NLR 四分位数组的 3 年 HCC 累积发生率分别为 4.8%、8.4%、13.2%和 18.0%（P<0.001）。与 NLR 最低四分位组相比，较高的 NLR 与 HCC 发生风险增加相关[NLR 1.4-2.0：调整后的危险比（aHR），1.18（95%置信区间（CI），1.11-1.25）；NLR 2.0-3.0：aHR，2.09（95% CI，1.19-3.66）；NLR>3.0：aHR，2.80（95% CI，1.59-4.95）；趋势 P 值=0.001]。在全调整模型中，亚组分析结果一致。
对于接受抗病毒治疗的 HBC 患者，升高的 NLR 是 HCC 发生的独立危险因素。
