Blood Neutrophil-to-Lymphocyte Ratio Predicts Tumor Recurrence in Patients with Hepatocellular Carcinoma within Milan Criteria after Hepatectomy
2
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
Purpose: The systemic inflammation biomarker, Neutrophil-to-Lymphocyte Ratio (NLR), has been reported as one of the adverseprognostic factors for hepatocellular carcinoma (HCC) patient. The purpose of this study was to evaluate whether NLR could predictthe risk of recurrence and death for the HCC patient, according to Milan criteria after hepatectomy. Materials and Methods: Retrospective analysis was performed on a database of HCC patients who underwent hepatectomy betweenMarch 2001 and December 2011. The cutoff value of NLR was decided by receiver operating characteristic (ROC) curve analysis. Univariate and multivariate regression analyses were performed to identify predictive factors of recurrence and death. Results: A total of 213 patients were included in the present study. The median follow-up period was 48 months. One hundred andseven patients were experienced tumor recurrence; forty of them recurred within 12 months (early recurrence). NLR ≥1.505, albumin≤3.75 g/dL, microvascular invasion and high grade of cirrhosis were found to be independent factors for adverse recurrence-freesurvival in multivariate regression analysis. And NLR ≥1.945 was also found as a prognosis factor for early recurrence by univariateregression analysis. Conclusion: Elevated preoperative NLR can be easily obtained and reliable biomarker for assessing the tumor recurrence and earlyrecurrence of Milan criteria HCC after the initial hepatectomy.
Abstract
Purpose: The systemic inflammation biomarker, Neutrophil-to-Lymphocyte Ratio (NLR), has been reported as one of the adverseprognostic factors for hepatocellular carcinoma (HCC) patient. The purpose of this study was to evaluate whether NLR could predictthe risk of recurrence and death for the HCC patient, according to Milan criteria after hepatectomy. Materials and Methods: Retrospective analysis was performed on a database of HCC patients who underwent hepatectomy betweenMarch 2001 and December 2011. The cutoff value of NLR was decided by receiver operating characteristic (ROC) curve analysis. Univariate and multivariate regression analyses were performed to identify predictive factors of recurrence and death. Results: A total of 213 patients were included in the present study. The median follow-up period was 48 months. One hundred andseven patients were experienced tumor recurrence; forty of them recurred within 12 months (early recurrence). NLR ≥1.505, albumin≤3.75 g/dL, microvascular invasion and high grade of cirrhosis were found to be independent factors for adverse recurrence-freesurvival in multivariate regression analysis. And NLR ≥1.945 was also found as a prognosis factor for early recurrence by univariateregression analysis. Conclusion: Elevated preoperative NLR can be easily obtained and reliable biomarker for assessing the tumor recurrence and earlyrecurrence of Milan criteria HCC after the initial hepatectomy.
참고문헌 (36)
- Song IH, "Current status of liver diseases in Korea: hepatocellular carcinoma", Korean J Hepatol, 15(Suppl 6), pp.S50~S59 (2009)
- Park KW, "Survival analysis of 904 patients with hepatocellular carcinoma in a hepatitis B virus-endemic area", J Gastroenterol Hepatol, 23, pp.467~473 (2008)
- 김병호, "1990년대 진단된 간세포암의 시기에 다른 임상적 특징 비교", 대한소화기학회지, 42(4) (2003), 대한소화기학회
- Minagawa M, "Selection criteria for repeat hepatectomy in patients with recurrent hepatocellular carcinoma", Ann Surg, 238, pp.703~710 (2003)
- Zahorec R, "Ratio of neutrophil to lymphocyte counts--rapid and simple parameter of systemic inflammation and stress in critically ill", Bratisl Lek Listy, 102, pp.5~14 (2001)
- Gomez D, "Preoperative neutrophil-to-lymphocyte ratio as a prognostic predictor after curative resection for hepatocellular carcinoma", World J Surg, 32, pp.1757~1762 (2008)
- Mano Y, "Preoperative neutrophil-to-lymphocyte ratio is a predictor of survival after hepatectomy for hepatocellular carcinoma: a retrospective analysis", Ann Surg, 258, pp.301~305 (2013)
- Liao W, "Preoperative neutrophil-to-lymphocyte ratio as a new prognostic marker in hepatocellular carcinoma after curative resection", Transl Oncol, 7, pp.248~255 (2014)
- Huang ZL, "Blood neutrophil-tolymphocyte ratio predicts survival in patients with unresectable hepatocellular carcinoma undergoing transarterial chemoembolization", J Vasc Interv Radiol, 22, pp.702~709 (2011)
- Chen TM, "Neutrophil-to-lymphocyte ratio associated with mortality in early hepatocellular carcinoma patients after radiofrequency ablation", J Gastroenterol Hepatol, 27, pp.553~561 (2012)
- Halazun KJ, "Negative impact of neutrophil-lymphocyte ratio on outcome after liver transplantation for hepatocellular carcinoma", Ann Surg, 250, pp.141~151 (2009)
- Motomura T, "Neutrophil-lymphocyte ratio reflects hepatocellular carcinoma recurrence after liver transplantation via inflammatory microenvironment", J Hepatol, 58, pp.58~64 (2013)
- Harimoto N, "Prognostic factors affecting survival at recurrence of hepatocellular carcinoma after living-donor liver transplantation:with special reference to neutrophil", lymphocyte ratio, 2013, pp.96, 1008~1012
- Tajiri K, "Neutrophil", lymphocyte ratio as a prognostic indicator of hepatic arterial infusion chemotherapy with arterial cisplatin plus continuous 5-fluorouracil, 2015, pp.45, 755~763
- Zheng YB, "The blood neutrophil-to-lymphocyte ratio predicts survival in patients with advanced hepatocellular carcinoma receiving sorafenib", Asian Pac J Cancer Prev, 14, pp.5527~5531 (2013)
- Desmet VJ, "Classification of chronic hepatitis: diagnosis, grading and staging", Hepatology, 19, pp.1513~1520 (1994)
- Edmondson HA, "Primary carcinoma of the liver: a study of 100 cases among 48,900 necropsies", Cancer, 7, pp.462~503 (1954)
- Balkwill F, "Inflammation and cancer: back to Virchow?", Lancet, 357, pp.539~545 (2001)
- Grivennikov SI, "Immunity, inflammation, and cancer", Cell, 140, pp.883~899 (2010)
- Capece D, "The inflammatory microenvironment in hepatocellular carcinoma: a pivotal role for tumor-associated macrophages", Biomed Res Int, 2013, pp.187204~ (2013)
- Hotchkiss KA, "Schwartz EL. Mechanisms by which tumor cells and monocytes expressing the angiogenic factor thymidine phosphorylase mediate human endothelial cell migration", Cancer Res, 63, pp.527~533 (2003)
- Marconi C, "Tumoral and macrophage uPAR and MMP-9 contribute to the invasiveness of B16 murine melanoma cells", Clin Exp Metastasis, 25, pp.225~231 (2008)
- Peng SH, "Significance and relationship between infiltrating inflammatory cell and tumor angiogenesis in hepatocellular carcinoma tissues", World J Gastroenterol, 11, pp.6521~6524 (2005)
- Borish L, "Activation of neutrophils by recombinant interleukin 6", Cell Immunol, 121, pp.280~289 (1989)
- Maniecki MB, "Tumor-promoting macrophages induce the expression of the macrophage-specific receptor CD163 in malignant cells", Int J Cancer, 131, pp.2320~2331 (2012)
- Varney ML, "Monocyte", macrophage recruitment, activation and differentiation modulate interleukin-8 production: a paracrine role of tumor-associated macrophages in tumor angiogenesis, 2002, pp.16, 471~477
- Zhao Q, "Interleukin17-educated monocytes suppress cytotoxic T-cell function through B7-H1 in hepatocellular carcinoma patients", Eur J Immunol, 41, pp.2314~2322 (2011)
- Kuang DM, "Activated monocytes in peritumoral stroma of hepatocellular carcinoma promote expansion of memory T helper 17 cells", Hepatology, 51, pp.154~164 (2010)
- Kuang DM, "Tumor-activated monocytes promote expansion of IL-17-producing CD8+ T cells in hepatocellular carcinoma patients", J Immunol, 185, pp.1544~1549 (2010)
- Sumie S, "Fukushima N, et al. Microvascular invasion in patients with hepatocellular carcinoma and its predictable clinicopathological factors", Ann Surg Oncol, 15, pp.1375~1382 (2008)
- Poon RT, "Different risk factors and prognosis for early and late intrahepatic recurrence after resection of hepatocellular carcinoma", Cancer, 89, pp.500~507 (2000)
- Yamamoto J, "Recurrence of hepatocellular carcinoma after surgery", Br J Surg, 83, pp.1219~1222 (1996)
- Cruz NG, "The linkage between inflammation and Type 2 diabetes mellitus", Diabetes Res Clin Pract, 99, pp.85~92 (2013)
- Shau WY, "Diabetes mellitus is associated with increased mortality in patients receiving curative therapy for hepatocellular carcinoma", Oncologist, 17, pp.856~862 (2012)
- Wang YY, "Impact of diabetes mellitus on the prognosis of patients with hepatocellular carcinoma after curative hepatectomy", PLoS One, 9, pp.e113858~ (2014)
- Poon RT, "Does diabetes mellitus influence the perioperative outcome or long term prognosis after resection of hepatocellular carcinoma?", Am J Gastroenterol, 97, pp.1480~1488 (2002)