Li Shu-Xian, Bao Yan, Wang Tian-Cheng
Department of Radiology, The Second Xiangya Hospital of Central South University, Changsha, China.
Sci Prog. 2024 Oct-Dec;107(4):368504241304195. doi: 10.1177/00368504241304195.
Both subcutaneous adipose tissue (SAT) and neutrophil-to-lymphocyte ratio (NLR) are associated with the prognosis of hepatocellular carcinoma (HCC). Subcutaneous adipose tissue is an immunonutritional indicator, and NLR reflects the inflammatory status. The purpose of this study was to ascertain the validity of SAT/NLR as potential prognostic biomarkers in HCC patients who are undergoing liver resection.
This retrospective study encompassed the sequential enrollment of 682 patients diagnosed with HCC who underwent liver resection. The patients were categorized into high and low SAT/NLR groups using the median value, and forward stepwise logistic regression was utilized to ascertain independent predictors for one-year HCC recurrence. In order to minimize the influence of confounding variables, a propensity score matching (PSM) analysis was conducted between patients in high and low SAT/NLR groups. The Kaplan-Meier method was employed to assess and compare the recurrence-free survival (RFS) and overall survival (OS) between the two groups.
The study divided patients into two groups based on their SAT/NLR levels: high SAT/NLR (≥35.34) and low SAT/NLR (<35.34) groups. Forward stepwise logistic regression analysis revealed that low SAT/NLR ( < 0.001), tumor size ≥50 mm ( < 0.001), alpha-fetoprotein level >200 ng/mL ( < 0.001), and presence of liver cirrhosis ( < 0.001) were significantly associated with one-year recurrence of HCC. Moreover, the results suggest that RFS and OS were significantly shorter in the low SAT/NLR group compared to the high SAT/NLR group, both before and after PSM ( < 0.05).
The preoperative biomarker SAT/NLR shows potential as a prognostic biomarker for one-year recurrence and prognosis in patients with HCC undergoing liver resection.
皮下脂肪组织（SAT）和中性粒细胞与淋巴细胞比值（NLR）均与肝细胞癌（HCC）的预后相关。皮下脂肪组织是一种免疫营养指标，而NLR反映炎症状态。本研究的目的是确定SAT/NLR作为接受肝切除术的HCC患者潜在预后生物标志物的有效性。
这项回顾性研究纳入了682例诊断为HCC并接受肝切除术的患者。使用中位数将患者分为SAT/NLR高分组和低分组，并采用向前逐步逻辑回归来确定HCC一年复发的独立预测因素。为了尽量减少混杂变量的影响，在SAT/NLR高分组和低分组患者之间进行了倾向评分匹配（PSM）分析。采用Kaplan-Meier方法评估和比较两组之间的无复发生存期（RFS）和总生存期（OS）。
该研究根据患者的SAT/NLR水平将其分为两组：SAT/NLR高组（≥35.34）和SAT/NLR低组（<35.34）。向前逐步逻辑回归分析显示，低SAT/NLR（<0.001）、肿瘤大小≥50 mm（<0.001）、甲胎蛋白水平>200 ng/mL（<0.001）以及存在肝硬化（<0.001）与HCC一年复发显著相关。此外，结果表明，无论在PSM之前还是之后，SAT/NLR低组的RFS和OS均显著短于高分组（<0.05）。
术前生物标志物SAT/NLR显示出作为接受肝切除术的HCC患者一年复发和预后的预后生物标志物的潜力。
