Young Shamar, Ragulojan Ranjan, Chen Ting, Owen Joshua, D'souza Donna, Sanghvi Tina, Golzarian Jafar, Flanagan Siobhan
University of Minnesota, Department of Radiology, Division of Interventional Radiology, Minneapolis, MN, 55455, USA.
Minneapolis VA Medical Center, Department of Radiology, Minneapolis, MN, 55455, USA.
J Hepatocell Carcinoma. 2022 Feb 4;9:29-39. doi: 10.2147/JHC.S350219. eCollection 2022.
To evaluate the dynamic changes of lymphocytes following transarterial radioembolization (TARE) for hepatocellular carcinoma (HCC) and their relationship to normal liver dose (NLD).
A total of 93 patients who underwent 102 treatments were retrospectively reviewed. Absolute lymphocyte counts pretreatment and at 1, 3, 6, and 12 months were evaluated. Kaplan-Meier, Spearman correlation, receiver operating characteristic (ROC) curve, and area under the curve (AUC) analyses were performed.
The mean absolute lymphocyte count at baseline was 1.25 ± 0.79 10/µL which was significantly greater than 1 (0.71 ± 0.47 10/µL, <0.0001), 3 (0.79 ± 0.77 10/µL, =0.0003), and 6 (0.81 ± 0.44 10/µL, =0.0001) months, but not significantly different than 12 (0.92 ± 0.8 10/µL, =0.12) months post treatment. There was a modest negative correlation between NLD and lymphocyte count at 1 month (rho= -0.216, =0.03), which strengthened at 3 months post treatment (rho= -0.342, =0.008). AUC of ROC analysis between absolute lymphocyte count ≤1 10/µL or >1 10/µL at 1, 3, 6, and 12 months post treatment was 0.625, 0.676, 0.560, and 0.794, respectively. Univariate analysis of overall survival when separating patients by a lymphocyte count of ≤1 10/µL and >1 10/µL demonstrated a significant difference at 1 (HR: 0.56, 95% CI: 0.33-0.95, =0.03), 3 (HR: 0.41, 95% CI: 0.18-0.94, =0.035) and 6 (HR: 0.36, 95% CI: 0.17-0.77, =0.008) months post treatment, but not pretreatment or at 12 months.
NLD may correlate with lymphocyte depression at 1 and 3 months and lymphopenia may portend a worse overall survival in the post treatment setting.
评估经动脉放射性栓塞术（TARE）治疗肝细胞癌（HCC）后淋巴细胞的动态变化及其与正常肝脏剂量（NLD）的关系。
回顾性分析了93例接受102次治疗的患者。评估治疗前及治疗后1、3、6和12个月时的绝对淋巴细胞计数。进行了Kaplan-Meier分析、Spearman相关性分析、受试者操作特征（ROC）曲线分析及曲线下面积（AUC）分析。
基线时平均绝对淋巴细胞计数为1.25±0.79×10⁹/μL，显著高于治疗后1个月（0.71±0.47×10⁹/μL，P<0.0001）、3个月（0.79±0.77×10⁹/μL，P = 0.0003）和6个月（0.81±0.44×10⁹/μL，P = 0.0001），但与治疗后12个月（0.92±0.8×10⁹/μL，P = 0.12）无显著差异。NLD与1个月时的淋巴细胞计数呈适度负相关（rho = -0.216，P = 0.03），治疗后3个月时相关性增强（rho = -0.342，P = 0.008）。治疗后1、3、6和12个月时，绝对淋巴细胞计数≤1×10⁹/μL或>1×10⁹/μL的ROC分析AUC分别为0.625、0.676、0.560和0.794。根据淋巴细胞计数≤1×10⁹/μL和>1×10⁹/μL对患者进行分组的总生存单因素分析显示，治疗后1个月（HR：0.56，95%CI：0.33 - 0.95，P = 0.03）、3个月（HR：0.41，95%CI：0.18 - 0.94，P = 0.035）和6个月（HR：0.36，95%CI：0.17 - 0.77，P = 0.008）存在显著差异，但治疗前及12个月时无差异。
NLD可能与治疗后1个月和3个月时的淋巴细胞减少有关，淋巴细胞减少可能预示治疗后总体生存情况较差。
