Hong Young Mi, Cho Mong, Yoon Ki Tae, Ryu Je Ho, Yang Kwang Ho, Hwang Tae Ho
Department of Internal Medicine, Pusan National University School of Medicine, Liver center, Pusan National University Yangsan Hospital, Yangsan, Korea.
Department of Surgery, Pusan National University School of Medicine, Division of Hepato-Biliary-Pancreatic Surgery and Transplantation, Pusan National University Yangsan Hospital, Yangsan, Korea.
Korean J Transplant. 2020 Jun 30;34(2):92-99. doi: 10.4285/kjt.2020.34.2.92.
The Milan criteria (MC) used to select patients for liver transplantation among patients with hepatocellular carcinoma (HCC) do not include tumor biology. Furthermore, systemic inflammatory markers have been identified to predict tumor biology. The present study investigated prognostic value of systemic inflammatory markers, including neutrophil count, in predicting the prognosis of patients with HCC undergoing living donor liver transplantation (LDLT).
We retrospectively analyzed data regarding peripheral blood inflammatory markers, as well as patient and tumor characteristics of patients with HCC who underwent LDLT. Univariate and multivariate analyses were performed to analyze variables associated with survival.
A total of 103 patients with HCC who underwent LDLT were included. The 3- and 5-year recurrence-free survival (RFS) in patients with a high neutrophil count (>2,640/µL) were significantly lower than those in patients with a low neutrophil count (≤2,640/µL; 70.0% and 64.7% vs. 88.3% and 84.6%, respectively; P=0.02). Patients with a high neutrophil count also had lower 5-year overall survival (OS; 63.9% vs. 79.3%, P=0.03). In multivariate analysis, radiologic MC (hazard ratio [HR], 5.04; P=0.02) and neutrophil count (HR, 4.47; P=0.04) were independent factors predicting RFS. Among patients exceeding the MC, those with a high neutrophil count had significantly lower 5-year RFS than those with low neutrophil count (10% vs. 83%; P<0.01).
We demonstrated that high preoperative neutrophil count is associated with poor RFS and OS in patients with HCC undergoing LDLT.
用于在肝细胞癌（HCC）患者中选择肝移植受者的米兰标准（MC）未纳入肿瘤生物学因素。此外，已确定全身炎症标志物可预测肿瘤生物学特性。本研究探讨了包括中性粒细胞计数在内的全身炎症标志物对接受活体肝移植（LDLT）的HCC患者预后的预测价值。
我们回顾性分析了接受LDLT的HCC患者的外周血炎症标志物数据以及患者和肿瘤特征。进行单因素和多因素分析以分析与生存相关的变量。
共纳入103例接受LDLT的HCC患者。中性粒细胞计数高（>2,640/µL）的患者3年和5年无复发生存率（RFS）显著低于中性粒细胞计数低（≤2,640/µL）的患者（分别为70.0%和64.7% 对88.3%和84.6%；P=0.02）。中性粒细胞计数高的患者5年总生存率（OS）也较低（63.9%对79.3%，P=0.03）。多因素分析中，放射学米兰标准（风险比[HR]，5.04；P=0.02）和中性粒细胞计数（HR，4.47；P=0.04）是预测RFS的独立因素。在超过米兰标准的患者中，中性粒细胞计数高的患者5年RFS显著低于中性粒细胞计数低的患者（10%对83%；P<0.01）。
我们证明术前中性粒细胞计数高与接受LDLT的HCC患者的RFS和OS较差相关。
