Department of Surgery, National Hospital Organization Fukuyama Medical Center, Fukuyama, Japan
Department of Surgery, National Hospital Organization Fukuyama Medical Center, Fukuyama, Japan.
Anticancer Res. 2022 Oct;42(10):4963-4971. doi: 10.21873/anticanres.16003.
BACKGROUND/AIM: Preoperative systemic inflammation has been reported to predict survival in patients with various cancer types. In patients with colorectal liver metastasis (CRLM), the prognosis is poor despite therapeutic advances in the field. Here, we aimed to evaluate the prognostic role of the lymphocyte-to-C-reactive protein (CRP) ratio (LCR) in patients with CRLM after hepatic resection.
This retrospective study included 104 patients who underwent hepatic resection for CRLM between October 2010 and 2021 at the National Hospital Organization Fukuyama Medical Center, Hiroshima, Japan. The association between clinicopathological variables, including various inflammatory biomarkers [LCR, platelet-to-lymphocyte ratio (PLR), neutrophil-to-lymphocyte ratio (NLR), CRP-to-albumin ratio (CAR), and prognostic nutritional index (PNI)], and overall survival of the patients was investigated using univariate and multivariate analyses.
The optimal cut-off values for each biomarker by receiver-operating characteristic analysis were as follows: LCR: 12,720; PLR: 150; NLR: 4; CAR: 0.023; and PNI: 44.8. The 1-, 3-, and 5-year overall survival rates were 97.0%, 71.3%, and 56.8%, respectively. On univariate analysis, LCR<12, 720, PLR<0.14, body mass index <24 kg/m, carbohydrate antigen 19-9 ≥37 U/ml, multiple tumours, and largest hepatic tumour ≥5 cm were significant factors predictive of poorer survival. The multivariate analysis revealed that LCR<12, 720 (hazard ratio=2.156, 95% confidence interval=1.060-4.509, p=0.034) and multiple tumours (HR=2.336, 95% CI=1.125-4.925, p=0.023) were independent predictors of poor overall survival.
LCR may be an independent prognostic predictor in patients after hepatic resection for CRLM. Therefore, the assessment of LCR as a biomarker may help in treatment planning.
背景/目的：术前全身炎症已被报道可预测多种癌症类型患者的生存情况。在结直肠癌肝转移（CRLM）患者中，尽管该领域的治疗取得了进展，但预后仍较差。在此，我们旨在评估淋巴细胞与 C 反应蛋白（CRP）比值（LCR）在接受肝切除的 CRLM 患者中的预后作用。
本回顾性研究纳入了 2010 年 10 月至 2021 年在日本广岛县国立医院组织福冈医疗中心接受肝切除术治疗 CRLM 的 104 例患者。使用单变量和多变量分析，研究了包括各种炎症生物标志物（LCR、血小板与淋巴细胞比值（PLR）、中性粒细胞与淋巴细胞比值（NLR）、CRP 与白蛋白比值（CAR）和预后营养指数（PNI））在内的临床病理变量与患者总生存的关系。
通过受试者工作特征分析确定每个生物标志物的最佳截断值如下：LCR：12720；PLR：150；NLR：4；CAR：0.023；PNI：44.8。1、3 和 5 年总生存率分别为 97.0%、71.3%和 56.8%。单变量分析显示，LCR<12720、PLR<0.14、BMI<24kg/m2、CA19-9≥37U/ml、多发肿瘤和最大肝肿瘤≥5cm 是生存较差的显著预测因素。多变量分析显示，LCR<12720（风险比=2.156，95%置信区间=1.060-4.509，p=0.034）和多发肿瘤（HR=2.336，95%CI=1.125-4.925，p=0.023）是总生存不良的独立预测因素。
LCR 可能是 CRLM 患者肝切除术后的独立预后预测指标。因此，评估 LCR 作为生物标志物可能有助于治疗计划。
