Yugawa Kyohei, Maeda Takashi, Kinjo Nao, Kawata Koto, Ikeda Shinichiro, Edahiro Keitaro, Edagawa Makoto, Omine Takahiro, Kometani Takuro, Yamaguchi Shohei, Konishi Kozo, Tsutsui Shinichi, Matsuda Hiroyuki
Department of Surgery, Hiroshima Red Cross Hospital and Atomic-bomb Survivors Hospital, Hiroshima, 730-0052, Japan.
J Gastrointest Surg. 2022 Jan;26(1):104-112. doi: 10.1007/s11605-021-05085-z. Epub 2021 Jul 13.
Systemic inflammation-related factors, either independently or in combination, are recognized as prognostic factors for various cancers. The ratio of lymphocyte count to C-reactive protein concentration (lymphocyte-CRP ratio; LCR) is a recently identified prognostic marker for several cancers. Here, we examined the prognostic value of the LCR in patients with hepatocellular carcinoma (HCC).
This was a single-center retrospective study of patients who underwent surgical resection for HCC between 2004 and 2017. Patients were divided into high- and low-LCR status groups, and the relationships between LCR status, prognosis, and other clinicopathological characteristics were analyzed.
A total of 454 patients with HCC were enrolled and assigned to the high- (n=245) or low- (n=209) LCR groups. Compared with the high-LCR group, patients in the low-LCR group had a significantly lower serum albumin level (median 4.1 vs. 3.9 g/dL, P <0.0001), lower platelet count (median 14.0 vs. 12.0 ×10/μL, P=0.0468), lower prothrombin time (median 93.2 vs. 89.6 %, P=0.0006), and larger tumor size (median 2.3 vs. 2.5 cm, P=0.0056). Patients with low-LCR status had significantly worse outcomes of overall survival and disease-free survival than patients with high-LCR status (P=0.0003 and P=0.0069, respectively). Low-LCR status was significantly associated with worse overall survival in multivariate analysis (hazard ratio 1.57, 95% confidence interval 1.14-2.17, P=0.0058).
Low-LCR status may predict worse outcomes in patients with HCC. Measurement of LCR is routine and can easily be applied for risk stratification in the assessment of patients with HCC.
全身炎症相关因子，无论是单独还是联合作用，都被认为是多种癌症的预后因素。淋巴细胞计数与C反应蛋白浓度之比（淋巴细胞-C反应蛋白比值；LCR）是最近确定的几种癌症的预后标志物。在此，我们研究了LCR在肝细胞癌（HCC）患者中的预后价值。
这是一项对2004年至2017年间接受HCC手术切除患者的单中心回顾性研究。将患者分为高LCR状态组和低LCR状态组，并分析LCR状态、预后和其他临床病理特征之间的关系。
共纳入454例HCC患者，分为高LCR组（n=245）和低LCR组（n=209）。与高LCR组相比，低LCR组患者的血清白蛋白水平显著降低（中位数4.1 vs. 3.9 g/dL，P<0.0001），血小板计数更低（中位数14.0 vs. 12.0×10/μL，P=0.0468），凝血酶原时间更低（中位数93.2 vs. 89.6%，P=0.0006），肿瘤尺寸更大（中位数2.3 vs. 2.5 cm，P=0.0056）。低LCR状态患者的总生存期和无病生存期结局显著差于高LCR状态患者（分别为P=0.0003和P=0.0069）。在多变量分析中，低LCR状态与更差的总生存期显著相关（风险比1.57，95%置信区间1.14-2.17，P=0.0058）。
低LCR状态可能预示HCC患者预后更差。LCR的测量是常规操作，可轻松应用于HCC患者评估中的风险分层。
