Department of Ultrasound, Harbin Medical University Cancer Hospital, Harbin, China.
Br J Radiol. 2023 Apr 1;96(1145):20220887. doi: 10.1259/bjr.20220887. Epub 2023 Feb 14.
Previous studies focused on the prognostic significance of the pre- or post-operative neutrophil-lymphocyte ratio (NLR); the significance of combined pre- and post-operative NLR (PP-NLR) remains unknown. Therefore, we investigated the value of PP-NLR for predicting prognosis after radiofrequency ablation (RFA) in patients with hepatocellular carcinoma (HCC) to improve treatment and prolong survival.
We investigated pre- and post-operative NLR and PP-NLR in predicting prognosis after RFA in patients with HCC. Optimal thresholds for leukocytes, lymphocytes, neutrophils, and NLR before and after RFA were retrospectively assessed in patients with HCC who had undergone RFA between January 2018 and June 2019 in Harbin Medical University Cancer Hospital. Risk factors for early HCC recurrence and those affecting recurrence-free survival (RFS) were analyzed.
The respective pre- and post-operative optimal thresholds were as follows: neutrophils, 3.431 and 4.975; leukocytes, 5.575 and 6.61; lymphocytes, 1.455 and 1.025; and NLR, 1.53 and 4.36. Univariate analysis revealed tumor number; alpha-fetoprotein level; post-operative leukocytes, lymphocytes, NLR, and neutrophils; pre-operative neutrophils and NLR; and PP-NLR as factors influencing early recurrence and RFS. Multivariate analysis indicated PP-NLR as an independent risk factor for poor RFS and early recurrence.
PP-NLR was more effective for predicting prognosis than pre- or post-operative NLR alone for patients with HCC.
The novelty of this study lies in the combination of pre- and post-operative NLR, namely PP-NLR, to study its prognostic value for HCC patients after RFA, which has not been found in previous studies. The contribution of our study is that PP-NLR can provide clinicians with a new reference index to judge the prognosis of patients and make timely treatment to help patients improve their prognosis.
先前的研究集中于术前或术后中性粒细胞-淋巴细胞比值（NLR）的预后意义；联合术前和术后 NLR（PP-NLR）的意义尚不清楚。因此，我们研究了 PP-NLR 预测肝癌（HCC）患者射频消融（RFA）后预后的价值，以改善治疗并延长生存。
我们研究了 HCC 患者 RFA 前后 NLR 和 PP-NLR 对预后的预测价值。回顾性评估了 2018 年 1 月至 2019 年 6 月在哈尔滨医科大学附属肿瘤医院接受 RFA 的 HCC 患者的 RFA 前后 NLR 的最佳阈值。分析了影响 HCC 早期复发和无复发生存（RFS）的危险因素。
分别为术前和术后的最佳阈值为：中性粒细胞 3.431 和 4.975；白细胞 5.575 和 6.61；淋巴细胞 1.455 和 1.025；NLR 1.53 和 4.36。单因素分析显示肿瘤数量、甲胎蛋白水平、术后白细胞、淋巴细胞、NLR 和中性粒细胞、术前中性粒细胞和 NLR、PP-NLR 是影响早期复发和 RFS 的因素。多因素分析表明 PP-NLR 是 RFS 和早期复发不良的独立危险因素。
PP-NLR 预测 HCC 患者 RFA 后预后的效果优于单独的术前或术后 NLR。
本研究的新颖之处在于将术前和术后 NLR 相结合，即 PP-NLR，研究其对 RFA 后 HCC 患者的预后价值，这在以前的研究中尚未发现。本研究的贡献在于，PP-NLR 可以为临床医生提供一个新的参考指标来判断患者的预后，并及时进行治疗，帮助患者改善预后。
