Utsumi Masashi, Inagaki Masaru, Kitada Koji, Tokunaga Naoyuki, Kondo Midori, Sakurai Yuya, Yunoki Kosuke, Hamano Ryosuke, Miyasou Hideaki, Tsunemitsu Yousuke, Otsuka Shinya
Department of Surgery, National Hospital Organization Fukuyama Medical Center, Fukuyama, Japan.
Ann Surg Treat Res. 2022 Aug;103(2):72-80. doi: 10.4174/astr.2022.103.2.72. Epub 2022 Aug 5.
This study was performed to determine the prognostic value of lymphocyte-to-CRP ratio after curative resection for hepatocellular carcinoma.
Between July 2010 and October 2021, 173 consecutive patients (144 male, 29 female) who underwent surgical resection for pathologically confirmed hepatocellular carcinoma were included in this retrospective study. Cox regression analysis was used to evaluate the relationship between clinicopathological characteristics and recurrence-free survival (RFS) and overall survival (OS). A P-value of <0.05 was considered statistically significant.
The patients (mean age, 71 years) were stratified into high (≥9,500, n = 108) and low (<9,500, n = 65) lymphocyte-to-CRP ratio groups. The low lymphocyte-to-CRP ratio group had significantly worse RFS and OS. Low lymphocyte-to-CRP ratio (hazard ratio [HR], 1.865; 95% confidence interval [CI], 1.176-2.960; P = 0.008), multiple tumors (HR, 3.333; 95% CI, 2.042-5.343; P < 0.001), and microvascular invasion (HR, 1.934; 95% CI, 1.178-3.184; P = 0.009) were independently associated with RFS, whereas low albumin-to-globulin ratio (HR, 2.270; 95% CI, 1.074-4.868; P = 0.032), α-FP of ≥25 ng/mL (HR, 2.187; 95% CI, 1.115-4.259; P = 0.023), and poor tumor differentiation (HR, 2.781; 95% CI, 1.041-6.692; P = 0.042) were independently associated with OS. Lymphocyte-to-CRP ratio had a higher area under the curve (0.635) than other inflammation-based markers (0.51-0.63).
Lymphocyte-to-CRP ratio is superior to other inflammation-based markers as a predictor of RFS in patients with surgically resected hepatocellular carcinoma.
本研究旨在确定肝细胞癌根治性切除术后淋巴细胞与C反应蛋白比值的预后价值。
在2010年7月至2021年10月期间，本回顾性研究纳入了173例连续接受手术切除且经病理证实为肝细胞癌的患者（男性144例，女性29例）。采用Cox回归分析评估临床病理特征与无复发生存期（RFS）和总生存期（OS）之间的关系。P值<0.05被认为具有统计学意义。
患者（平均年龄71岁）被分为淋巴细胞与C反应蛋白比值高（≥9500，n = 108）和低（<9500，n = 65）两组。淋巴细胞与C反应蛋白比值低的组RFS和OS明显更差。淋巴细胞与C反应蛋白比值低（风险比[HR]，1.865；95%置信区间[CI]，1.176 - 2.960；P = 0.008）、多发肿瘤（HR，3.333；95% CI，2.042 - 5.343；P < 0.001）和微血管侵犯（HR，1.934；95% CI，1.178 - 3.184；P = 0.009）与RFS独立相关，而低白蛋白球蛋白比值（HR，2.270；95% CI，1.074 - 4.868；P = 0.032）、α-甲胎蛋白≥25 ng/mL（HR，2.187；95% CI，1.115 - 4.259；P = 0.023）和肿瘤低分化（HR，2.781；95% CI，1.041 - 6.692；P = 0.042）与OS独立相关。淋巴细胞与C反应蛋白比值的曲线下面积（0.635）高于其他基于炎症的标志物（0.51 - 0.63）。
淋巴细胞与C反应蛋白比值作为手术切除肝细胞癌患者RFS的预测指标优于其他基于炎症的标志物。
