Predictive value of neutrophil-lymphocyte ratio and its dynamic change in patients with hepatocellular carcinoma undergoing transarterial chemoembolization

• Main Authors: WANG Wenjun, ZHAO Yan, XIA Dongdong
• Format: Article
• Language: zho
• Published: Editorial Department of Journal of Clinical Hepatology 2016-06-01
• Series: Linchuang Gandanbing Zazhi
• Online Access: http://www.lcgdbzz.org/qk_content.asp?id=7458

ObjectiveTo investigate the predictive value of neutrophil-lymphocyte ratio (NLR) and its dynamic change in patients with hepatocellular carcinoma (HCC) undergoing transarterial chemoembolization (TACE). MethodsThe patients who were diagnosed with HCC and treated with TACE in Xijing Hospital of Digestive Disease of Fourth Military Medical University from January 2010 to December 2014 were enrolled. The factors including NLR were recorded at baseline and 3 days and 1 month after TACE. The receiver operating characteristic (ROC) curve was used to determine the cut-off value of NLR. The t-test was used for comparison of continuous data between groups, the chi-square test was used for comparison of categorical data between groups, the Kaplan-Meier method was used to calculate survival rates, and univariate and multivariate Cox regression analyses were used for prognostic analysis. ResultsA total of 427 patients were enrolled. The median value of baseline NLR was 2.4; at 3 days after surgery, NLR increased and the median value reached 6.2; at 1 month after surgery, NLR decreased to the baseline level. The cut-off values at baseline, 3 days after surgery, and 1 month after surgery were 2.5, 9.7, and 2.5, respectively. At baseline, 3 days after surgery, and 1 month after surgery, the median survival time showed significant differences between the low-NLR group and the high-NLR group (χ2=10.529, 8.388, and 6.679, all P＜0.05). The multivariate Cox regression analysis showed that the baseline NLR ＞2.5 was the independent predictor for survival difference in HCC patients. In the group with low NLR at baseline and 3 days after surgery, the group with high NLR at baseline or 3 days after surgery, and the group with high NLR at baseline and 3 days after surgery, the median survival time was 28.0, 21.0, and 10.1 months, respectively, and showed a significant difference between groups (χ2=19.846, P＜0.001). In the group with low NLR at baseline and 1 month after surgery, the group with high NLR at baseline or 1 month after surgery, and the group with high NLR at baseline and 1 month after surgery, the median survival time was 29.4, 21.0, and 15.4 months, respectively, and showed a significant difference between groups (χ2=11.424, P=0.003). ConclusionBaseline NLR and its dynamic change can be used to predict the prognosis in HCC patients receiving TACE.