Wang Huaqi, Wang Zhiwei, Hou Zhenyu, Yang Xuejiao, Zhu Keyun, Cao Manqing, Zhu Xiaolin, Li Huikai, Zhang Ti
Department of Hepatobiliary Surgery, Tianjin Medical University Cancer Institute and Hospital; Liver Cancer Center, Tianjin Medical University Cancer Institute and Hospital; National Clinical Research Center for Cancer; Key Laboratory of Cancer Prevention and Therapy, Tianjin; Tianjin's Clinical Research Center for Cancer, Tianjin, 300060, People's Republic of China.
Department of Breast Surgery, Tianjin Medical University Cancer Institute & Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin, People's Republic of China.
Cancer Manag Res. 2021 Sep 7;13:6989-6998. doi: 10.2147/CMAR.S311526. eCollection 2021.
Patients with hepatocellular carcinoma (HCC) who might benefit most from anti-angiogenesis therapy remain unknown. In recent years, neutrophil-to-lymphocyte ratio (NLR), an indicator of inflammatory response, has received particular attention in HCC. Herein, we explored the prognostic value of pre-treatment NLR in individuals with unresectable intermediate and advanced hepatocellular carcinoma treated with apatinib, a second-line angiogenesis inhibitor. The findings of this study would assist in precision medicine and provide clinical decision support.
This is a retrospective study in which 171 HCC patients attending Tianjin Medical University Cancer Institute and Hospital and treated with apatinib between January 2016 and July 2018 were enrolled. The prognosis of the patients based on NLR signatures was then analyzed.
Patients with a low pre-treatment NLR (NLR < 2.49) presented a significantly longer overall survival (OS) (P < 0.001) and progression-free survival (PFS) (P = 0.043). Furthermore, a low pre-treatment NLR level could be used to predict a longer OS in patients with non-macrovascular invasion (P < 0.001). Independent of serum alpha-fetoprotein (AFP) levels, a low NLR level in this cohort of patients is associated with a longer OS.
Pre-treatment NLR predicts the prognosis of patients with unresectable intermediate and advanced HCC treated with apatinib.
最能从抗血管生成治疗中获益的肝细胞癌（HCC）患者仍不明确。近年来，作为炎症反应指标的中性粒细胞与淋巴细胞比值（NLR）在HCC中受到了特别关注。在此，我们探讨了治疗前NLR对接受二线血管生成抑制剂阿帕替尼治疗的不可切除的中晚期肝细胞癌患者的预后价值。本研究结果将有助于精准医学并提供临床决策支持。
这是一项回顾性研究，纳入了2016年1月至2018年7月期间在天津医科大学肿瘤医院就诊并接受阿帕替尼治疗的171例HCC患者。然后根据NLR特征分析患者的预后。
治疗前NLR较低（NLR < 2.49）的患者总生存期（OS）显著更长（P < 0.001），无进展生存期（PFS）也更长（P = 0.043）。此外，治疗前NLR水平较低可用于预测无大血管侵犯患者的更长OS（P < 0.001）。在本队列患者中，NLR水平较低与更长的OS相关，且独立于血清甲胎蛋白（AFP）水平。
治疗前NLR可预测接受阿帕替尼治疗的不可切除的中晚期HCC患者的预后。
