Tumor Biol. (2014) 35:11057–11063 DOI 10.1007/s13277-014-2360-8
RESEARCH ARTICLE
Neutrophil-to-lymphocyte ratio acts as a prognostic factor for patients with advanced hepatocellular carcinoma Xing Li & Zhan-Hong Chen & Xiao-Kun Ma & Jie Chen & Dong-Hao Wu & Qu Lin & Min Dong & Li Wei & Tian-Tian Wang & Dan-Yun Ruan & Ze-Xiao Lin & Yan-Fang Xing & Yun Deng & Xiang-Yuan Wu & Jin-Yun Wen
Received: 12 June 2014 / Accepted: 14 July 2014 / Published online: 6 August 2014 # International Society of Oncology and BioMarkers (ISOBM) 2014
Abstract Few studies investigated the prognosis of patients with advanced hepatocellular carcinoma (aHCC). This study was aimed to determine the prognostic value of differential blood cell counts including blood white cells, neutrophil, lymphocyte, neutrophil-lymphocyte ratio (NLR), and platelet in patients with aHCC. A total of 205 ethnic Chinese aHCC patients receiving non-systematic sorafenib were analyzed retrospectively. The prognostic value of differential blood cell counts and NLR for overall survival (OS) was determined by integration into Cancer of the Liver Italian Program (CLIP) score system using backward elimination model of multivariate Cox regression. As a result, NLR was confirmed to be an independent predictor for OS (p = 0.001) with the rest
parameters presented negative results. Then, aHCC patients were dichotomized into two groups according to NLR values ≤2.43 or >2.43. Patients with low NLR presented lower CLIP score and higher 6-month survival rate (56.1 vs 25.9 %) compared with patients with high NLR level. Besides, low NLR level was associated with favorable prognostic factors such as lower α-fetoprotein, alkaline phosphatase, and total bilirubin, as well as decreased incidence of ascites, portal vein thrombosis, and metastasis. Besides, low NLR level was associated less white cells and neutrophil granulocytes, as well as more lymphocyte. In summary, the present study firstly indentified NLR as an independent prognostic factor in aHCC patients receiving no systematic sorafenib.
Xing Li, Zhan-Hong Chen, Yan-Fang Xing and Xiao-Kun Ma contributed equally to this work.
Keywords Neutrophil-lymphocyte ratio . Hepatocellular carcinoma . Prognosis . Blood cell counts . Score system
X. Li : Z.
RESEARCH ARTICLE
Neutrophil-to-lymphocyte ratio acts as a prognostic factor for patients with advanced hepatocellular carcinoma Xing Li & Zhan-Hong Chen & Xiao-Kun Ma & Jie Chen & Dong-Hao Wu & Qu Lin & Min Dong & Li Wei & Tian-Tian Wang & Dan-Yun Ruan & Ze-Xiao Lin & Yan-Fang Xing & Yun Deng & Xiang-Yuan Wu & Jin-Yun Wen
Received: 12 June 2014 / Accepted: 14 July 2014 / Published online: 6 August 2014 # International Society of Oncology and BioMarkers (ISOBM) 2014
Abstract Few studies investigated the prognosis of patients with advanced hepatocellular carcinoma (aHCC). This study was aimed to determine the prognostic value of differential blood cell counts including blood white cells, neutrophil, lymphocyte, neutrophil-lymphocyte ratio (NLR), and platelet in patients with aHCC. A total of 205 ethnic Chinese aHCC patients receiving non-systematic sorafenib were analyzed retrospectively. The prognostic value of differential blood cell counts and NLR for overall survival (OS) was determined by integration into Cancer of the Liver Italian Program (CLIP) score system using backward elimination model of multivariate Cox regression. As a result, NLR was confirmed to be an independent predictor for OS (p = 0.001) with the rest
parameters presented negative results. Then, aHCC patients were dichotomized into two groups according to NLR values ≤2.43 or >2.43. Patients with low NLR presented lower CLIP score and higher 6-month survival rate (56.1 vs 25.9 %) compared with patients with high NLR level. Besides, low NLR level was associated with favorable prognostic factors such as lower α-fetoprotein, alkaline phosphatase, and total bilirubin, as well as decreased incidence of ascites, portal vein thrombosis, and metastasis. Besides, low NLR level was associated less white cells and neutrophil granulocytes, as well as more lymphocyte. In summary, the present study firstly indentified NLR as an independent prognostic factor in aHCC patients receiving no systematic sorafenib.
Xing Li, Zhan-Hong Chen, Yan-Fang Xing and Xiao-Kun Ma contributed equally to this work.
Keywords Neutrophil-lymphocyte ratio . Hepatocellular carcinoma . Prognosis . Blood cell counts . Score system
X. Li : Z.
