Yang Xue-Gang, Huang Ye-Cai, Wang Chun-Hua, Sun Yan-Yuan, Huang Zhi, Xu Guo-Hui
Department of Interventional Radiology, Sichuan Cancer Hospital and Institute, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China.
Department of Radiation Oncology, Sichuan Cancer Hospital and Institute, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China, Radiation Oncology Key Laboratory of Sichuan Province, Chengdu, China.
Cancer Invest. 2022 Jul;40(6):494-504. doi: 10.1080/07357907.2022.2065508. Epub 2022 Apr 20.
To determine the predictive value of preoperative inflammatory markers in hepatocellular carcinoma (HCC) prognosis after transarterial chemoembolization (TACE) combined with radiofrequency ablation (RFA).
A total of 161 patients with HCC who underwent TACE combined with RFA were enrolled in this retrospective study. Receiver operating characteristic (ROC) curve analysis was used to decide the cutoff value of the neutrophil-to-lymphocyte ratio (NLR), the lymphocyte-to-monocyte ratio (LMR), the platelet-to-lymphocyte ratio (PLR), and the prognostic nutritional index (PNI). The relationship between preoperative NLR, LMR, PLR, PNI, and survival outcomes was analyzed using Kaplan-Meier curves and multivariate Cox regression analyses.
The cutoff value of NLR for the best discrimination of HCC prognosis was 2.95. The median recurrence-free survival (RFS) of the low NLR (≤2.95) group was longer than that of the high NLR (>2.95) group (29 months vs. 20 months, = 0.013). The median overall survival (OS) of the low NLR group was longer than that of the high NLR group (60 months vs. 38 months, = 0.006). Multivariate analysis showed that the tumor size (≤3 cm vs. >3cm), tumor number (single vs. multiple), and NLR (≤2.95 vs. >2.95) were independent predictors of the PFS and OS. LMR, PLR, and PNI did not have any prognostic significance.
NLR was confirmed as an independent predictive biomarker for hepatocellular carcinoma prognosis after TACE combined with RFA.
确定术前炎症标志物对经动脉化疗栓塞术（TACE）联合射频消融术（RFA）治疗肝细胞癌（HCC）预后的预测价值。
本回顾性研究共纳入161例行TACE联合RFA治疗的HCC患者。采用受试者工作特征（ROC）曲线分析确定中性粒细胞与淋巴细胞比值（NLR）、淋巴细胞与单核细胞比值（LMR）、血小板与淋巴细胞比值（PLR）及预后营养指数（PNI）的临界值。采用Kaplan-Meier曲线和多因素Cox回归分析术前NLR、LMR、PLR、PNI与生存结局的关系。
NLR对HCC预后最佳判别临界值为2.95。低NLR（≤2.95）组的中位无复发生存期（RFS）长于高NLR（>2.95）组（29个月对20个月，P = 0.013）。低NLR组的中位总生存期（OS）长于高NLR组（60个月对38个月，P = 0.006）。多因素分析显示，肿瘤大小（≤3 cm对>3 cm）、肿瘤数量（单发对多发）和NLR（≤2.95对>2.95）是PFS和OS的独立预测因素。LMR、PLR和PNI无任何预后意义。
NLR被证实是TACE联合RFA治疗后肝细胞癌预后的独立预测生物标志物。
