Bae Bong Kyung, Park Hee Chul, Yoo Gyu Sang, Choi Moon Seok, Oh Joo Hyun, Yu Jeong Il
Department of Radiation Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, Korea.
Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, Korea.
Cancers (Basel). 2022 Apr 21;14(9):2081. doi: 10.3390/cancers14092081.
Systemic inflammatory markers (SIMs) are known to be associated with carcinogenesis and prognosis of hepatocellular carcinoma (HCC). We evaluated the significance of SIMs in intrahepatic recurrence (IHR) of early-stage HCC after curative treatment. This study was performed using prospectively collected registry data of newly diagnosed, previously untreated HCC between 2005 and 2017 at a single institution. Inclusion criteria were patients with Barcelona Clinic Liver Cancer stage 0 or A, who underwent curative treatment. Pre-treatment and post-treatment values of platelet, neutrophil, lymphocyte, monocyte, neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR), and lymphocyte/monocyte ratio (LMR) were analyzed with previously well-known risk factors of HCC to identify factors associated with IHR-free survival (IHRFS), early IHR, and late IHR. Of 4076 patients, 2142 patients (52.6%) experienced IHR, with early IHR in 1018 patients (25.0%) and late IHR in 1124 patients (27.6%). Pre-treatment platelet count and PLR and post-treatment worsening of NLR, PLR, and LMR were independently associated with IHRFS. Pre-treatment platelet count and post-treatment worsening of NLR, PLR, and LMR were significantly related to both early and late IHR. Pre-treatment values and post-treatment changes in SIMs were significant factors of IHR in early-stage HCC, independent of previously well-known risk factors of HCC.
已知全身炎症标志物（SIMs）与肝细胞癌（HCC）的致癌作用和预后相关。我们评估了SIMs在早期HCC根治性治疗后肝内复发（IHR）中的意义。本研究使用了前瞻性收集的2005年至2017年在单一机构新诊断、既往未治疗的HCC登记数据。纳入标准为巴塞罗那临床肝癌分期0或A且接受了根治性治疗的患者。分析了血小板、中性粒细胞、淋巴细胞、单核细胞、中性粒细胞/淋巴细胞比值（NLR）、血小板/淋巴细胞比值（PLR）和淋巴细胞/单核细胞比值（LMR）的治疗前和治疗后值，并结合HCC先前已知的危险因素，以确定与无肝内复发生存（IHRFS）、早期IHR和晚期IHR相关的因素。在4076例患者中，2142例患者（52.6%）发生IHR，其中1018例患者（25.0%）为早期IHR，1124例患者（27.6%）为晚期IHR。治疗前血小板计数和PLR以及治疗后NLR、PLR和LMR的恶化与IHRFS独立相关。治疗前血小板计数以及治疗后NLR、PLR和LMR的恶化与早期和晚期IHR均显著相关。SIMs的治疗前值和治疗后变化是早期HCC中IHR的重要因素，独立于HCC先前已知的危险因素。
