Neutrophil-to-lymphocyte ratio acts as a prognostic factor for patients with advanced hepatocellular carcinoma

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...

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Bibliographic Details
Published in:Tumor biology 2014-11, Vol.35 (11), p.11057-11063
Main Authors: Li, Xing, Chen, Zhan-Hong, Ma, Xiao-Kun, Chen, Jie, Wu, Dong-Hao, Lin, Qu, Dong, Min, Wei, Li, Wang, Tian-Tian, Ruan, Dan-Yun, Lin, Ze-Xiao, Xing, Yan-Fang, Deng, Yun, Wu, Xiang-Yuan, Wen, Jin-Yun
Format: Article
Language:English
Subjects:
Adult
Aged
Aged, 80 and over
Biomedical and Life Sciences
Biomedicine
Cancer Research
Carcinoma, Hepatocellular - mortality
Carcinoma, Hepatocellular - secondary
Cellular biology
Female
Follow-Up Studies
Humans
Leukocytes
Liver cancer
Liver Neoplasms - mortality
Liver Neoplasms - pathology
Lymphatic Metastasis
Lymphocytes
Lymphocytes - pathology
Male
Medical prognosis
Middle Aged
Neoplasm Invasiveness
Neoplasm Staging
Neutrophils - pathology
Prognosis
Research Article
Retrospective Studies
Survival Rate
Young Adult
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Summary: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.
ISSN:1010-4283
1423-0380
DOI:10.1007/s13277-014-2360-8