Research Center for Biomedical Resources, Beijing You'an Hospital, Capital Medical University, 8 Xitoutiao, Youanmenwai Street, Fengtai District, Beijing, 100069, China.
Interventional Therapy Center for Oncology, Beijing You'an Hospital, Capital Medical University, Beijing, 100069, China.
BMC Gastroenterol. 2022 Mar 4;22(1):98. doi: 10.1186/s12876-022-02180-6.
Monocyte to lymphocyte ratio (MLR) represents a pro-inflammatory immune microenvironment. The aim of this study was to elucidate the effect of MLR and subsequent MLR when relapse occurred (R-MLR) on prognosis for hepatocellular carcinoma (HCC) after transcatheter arterial chemoembolization (TACE) combined with ablation.
A prospective analysis was conducted on 606 patients with HCC who were treated with TACE combined with local ablation in Beijing You'an Hospital affiliated to Capital Medical University from January 1, 2012 to December 31, 2016. MLR or R-MLR were stratified according to the optimal cut-off values. The cumulative recurrence-free survival (RFS), overall survival (OS) , and recurrence-death survival (RDS) rates were calculated by Kaplan-Meier method. The Cox proportion hazard model and logistic regression analysis was conducted to screen for independent predictive factors for indicating early relapse and long-term prognosis.
High MLR was significantly associated with relapse, early recurrence, and overall survival. After a median follow-up of 59.4 months, The cumulative 1-, 3-, 5-year RFS rates of low MLR were 74.6%, 43.8%, and 34.0%; while 66.1%, 32.2%, and 22.6% for high group (P < 0.001). There were also significant differences in corresponding OS rates of the two groups (P = 0.003). The cumulative 1-, 3-, 5-year OS rates of low R-MLR were 99.5%, 87.2%, 75.5%; while 98.3%, 78.3%, 61.7% for high group (P < 0.001). There were also significant differences in corresponding RDS rates in the two groups (P = 0.008). 436 patients were divided into four groups on the base of cut-off values of MLR and R-MLR (low-low, low-high, high-low, and high-high). The low-low group has shown better outcomes including the cumulative 1-, 3-, 5-year OS, and RDS rates(P < 0.001).
High MLR was related to unfavorable outcome. Subsequent change of MLR between baseline and HCC relapse could indicate poor long-term survival after relapse.
单核细胞与淋巴细胞比值（MLR）代表了促炎免疫微环境。本研究旨在阐明经肝动脉化疗栓塞（TACE）联合消融治疗后，MLR 及其复发时的变化（R-MLR）对肝癌（HCC）预后的影响。
对 2012 年 1 月 1 日至 2016 年 12 月 31 日期间在北京佑安医院接受 TACE 联合局部消融治疗的 606 例 HCC 患者进行前瞻性分析。根据最佳截断值对 MLR 或 R-MLR 进行分层。通过 Kaplan-Meier 方法计算累积无复发生存率（RFS）、总生存率（OS）和复发-死亡生存率（RDS）。采用 Cox 比例风险模型和 logistic 回归分析筛选早期复发和长期预后的独立预测因素。
高 MLR 与复发、早期复发和总生存显著相关。中位随访 59.4 个月后，低 MLR 组的累积 1、3、5 年 RFS 率分别为 74.6%、43.8%和 34.0%，而高 MLR 组分别为 66.1%、32.2%和 22.6%（P<0.001）。两组 OS 率也存在显著差异（P=0.003）。低 R-MLR 组的累积 1、3、5 年 OS 率分别为 99.5%、87.2%和 75.5%，而高 R-MLR 组分别为 98.3%、78.3%和 61.7%（P<0.001）。两组的 RDS 率也存在显著差异（P=0.008）。基于 MLR 和 R-MLR 的截断值，436 例患者被分为四组（低-低、低-高、高-低和高-高）。低-低组的累积 1、3、5 年 OS 和 RDS 率均较好（P<0.001）。
高 MLR 与不良预后相关。HCC 复发时 MLR 的变化可提示复发后的长期生存不良。
