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中华普通外科学文献(电子版) ›› 2017, Vol. 11 ›› Issue (01) : 13 -17. doi: 10.3877/cma.j.issn.1674-0793.2017.01.004

所属专题: 文献

论著

术前血小板淋巴细胞比率对肝细胞癌患者的临床意义分析
邓国荣1,(), 陈博艺1, 李荣1, 刘宁江1, 钟其焕1, 王振龙1   
  1. 1. 524037 湛江中心人民医院肝胆外科
  • 收稿日期:2016-06-29 出版日期:2017-02-01
  • 通信作者: 邓国荣

Clinical impact of preoperative platelet-lymphocyte ratio on prognosis for hepatocellular carcinoma

Guorong Deng1,(), Boyi Chen1, Rong Li1, Ningjiang Liu1, Qihuan Zhong1, Zhenlong Wang1   

  1. 1. Department of Hepatobiliary Surgery, Central People’s Hospital of Zhanjiang, Zhanjiang 524037, China
  • Received:2016-06-29 Published:2017-02-01
  • Corresponding author: Guorong Deng
  • About author:
    Corresponding author: Deng Guorong, Email:
引用本文:

邓国荣, 陈博艺, 李荣, 刘宁江, 钟其焕, 王振龙. 术前血小板淋巴细胞比率对肝细胞癌患者的临床意义分析[J]. 中华普通外科学文献(电子版), 2017, 11(01): 13-17.

Guorong Deng, Boyi Chen, Rong Li, Ningjiang Liu, Qihuan Zhong, Zhenlong Wang. Clinical impact of preoperative platelet-lymphocyte ratio on prognosis for hepatocellular carcinoma[J]. Chinese Archives of General Surgery(Electronic Edition), 2017, 11(01): 13-17.

目的

探讨血小板淋巴细胞比率(PLR)对肝细胞癌(HCC)患者的预后是否具有预测意义。

方法

回顾性分析2000年4月至2010年12月间接受根治性肝切除手术的HCC患者392例,采用受试者工作特征(ROC)曲线计算PLR的最佳截点,分析PLR水平与患者流行病学数据、临床病理特征的关系。采用Kaplan-Meier法和Log-rank检验分析不同PLR组患者的总体生存差异,单因素及多因素分析用于评估各临床因素与预后的相关性。

结果

本组研究PLR最佳的截点是135。高PLR组(PLR≥135)中乙肝或丙肝病毒感染、肿瘤直径较大、AFP高以及进展期TNM的患者比例较高。低PLR组(PLR<135)的患者总体生存优于高PLR组,5年生存率分别为47.6%和21.5%,差异有高度统计学意义(P<0.01)。多因素回归分析结果显示高PLR水平、进展的TNM分期以及多个肿瘤是本组研究中总体预后不佳的独立预后因素(χ2=15.788、19.084、18.728,均P<0.01)。

结论

PLR可作为HCC患者的预测指标,PLR水平的升高提示总体预后不佳。

Objective

To investigate the clinical importance of preoperative platelet-lymphocyte ratio (PLR) in patients with hepatocellular carcinoma (HCC).

Methods

A retrospective analysis of consecutive three hundred and ninety-two non-metastatic HCC patients who underwent radical hepatectomy in our department between April 2000 and December 2010 was performed. Receiver operating characteristics (ROC) analysis was conducted to calculate the optimal cut-off value for PLR. Preoperative level of PLR, demographic, as well as clinical pathological parameters were analyzed. Kaplan-Meier method, univariate and multivariate analysis were performed to identify the clinicopathological variables associated with overall survival (OS).

Results

The optimal cut-off value was determined as 135 for PLR. The cases in the high PLR group (PLR≥135) had a significant tendency in terms of hepatitis B or C infection, higher AFP level, larger tumor size and advanced TNM stage. OS was significantly improved for patients with low PLR compared to patients with elevated values (5-year OS rate: 47.6% vs 21.5%, P<0.01). For multivariate analysis, elevated PLR, advanced TNM stage (Ⅲ+Ⅳstage), and multiple tumors were associated with poorer OS ( χ2=15.788, 19.084, 18.728, all P<0.01).

Conclusion

Preoperative PLR may be a powerful predictor for HCC patients, and those with elevated PLR level may indicate poorer prognosis.

图1 PLR与本组肝细胞癌患者生存状态的ROC曲线
表1 不同PLR水平与原发性肝癌临床病理特点的关系[例(%)]
图2 不同PLR水平与接受根治手术的HCC患者的总体预后分析
表2 影响原发性肝细胞癌总体生存的单因素分析结果
[1]
Tsuchiya N,Sawada Y,Endo I, et al. Biomarkers for the early diagnosis of hepatocellular carcinoma[J]. World J Gastroenterol, 2015, 21(37):10573-10583.
[2]
Tomimaru Y,Wada H,Eguchi H, et al. Clinical significance of surgical resection of metastatic lymph nodes from hepatocellular carcinoma[J]. Surg Today, 2015, 45(9): 1112-1120.
[3]
Song T. Recent advances in surgical treatment of hepatocellular carcinoma[J]. Drug Discov Ther, 2015, 9(5): 319-330.
[4]
Pan QX,Su ZJ,Zhang JH, et al. A comparison of the prognostic value of preoperative inflammation-based scores and TNM stage in patients with gastric cancer[J]. Onco Targets Ther, 2015, 8: 1375-1385.
[5]
邓国荣,陈博艺,李荣, 等. 中性粒细胞淋巴细胞比率与原发性肝癌预后的相关分析[J/CD]. 消化肿瘤杂志(电子版), 2014, 6(4): 213-216.
[6]
Kayadibi H,Sertoglu E,Uyanik M, et al. Neutrophil-lymphocyte ratio is useful for the prognosis of patients with hepatocellular carcinoma[J]. World J Gastroenterol, 2014, 20(28): 9631-9632.
[7]
Fujiwara N,Tateishi R,Nakagawa H, et al. Slight elevation of high-sensitivity C-reactive protein to predict recurrence and survival in patients with early stage hepatitis C-related hepatocellular carcinoma[J]. Hepatol Res, 2015, 45(6): 645-655.
[8]
Li MX,Bi XY,Li ZY, et al. Prognostic role of Glasgow prognostic score in patients with hepatocellular carcinoma: a systematic review and Meta-analysis[J]. Medicine (Baltimore), 2015, 94(49): e2133.
[9]
Aldemir MN,Turkeli M,Simsek M, et al. Prognostic value of baseline neutrophil-Lymphocyte and platelet-lymphocyte ratios in local and advanced gastric cancer patients[J]. Asian Pac J Cancer Prev, 2015, 16(14): 5933-5937.
[10]
Kilincalp S,Çoban Ş,Akinci H, et al. Neutrophil/lymphocyte ratio, platelet/lymphocyte ratio, and mean platelet volume as potential biomarkers for early detection and monitoring of colorectal adenocarcinoma[J]. Eur J Cancer Prev, 2015, 24(4): 328-333.
[11]
Smith RA,Bosonnet L,Raraty M, et al. Preoperative platelet-lymphocyte ratio is an independent significant prognostic marker in resected pancreatic ductal adenocarcinoma[J]. Am J Surg, 2009, 197(4): 466-472.
[12]
Hu B,Yang XR,Xu Y, et al. Systemic immune-inflammation index predicts prognosis of patients after curative resection for hepatocellular carcinoma[J]. Clin Cancer Res, 2014, 20(23): 6212-6222.
[13]
Coupland LA,Parish CR. Platelets, selectins, and the control of tumor metastasis[J]. Semin Oncol, 2014, 41(3): 422-434.
[14]
Quigley DA,Kristensen V. Predicting prognosis and therapeutic response from interactions between lymphocytes and tumor cells[J]. Mol Oncol, 2015, 9(10): 2054-2062.
[15]
Yang Z,Zhang J,Lu Y, et al. Aspartate aminotransferase-lymphocyte ratio index and systemic immune-inflammation index predict overall survival in HBV-related hepatocellular carcinoma patients after transcatheter arterial chemoembolization[J]. Oncotarget, 2015, 6(40): 43090-43098.
[16]
Xia W,Ke Q,Wang Y, et al. Predictive value of pre-transplant platelet to lymphocyte ratio for hepatocellular carcinoma recurrence after liver transplantation[J]. World J Surg Oncol, 2015, 13: 60.
[17]
Li X,Chen ZH,Ma XK, et al. Neutrophil-to-lymphocyte ratio acts as a prognostic factor for patients with advanced hepatocellular carcinoma[J]. Tumour Biol, 2014, 35(11): 11057-11063.
[18]
Zhang WW,Liu KJ,Hu GL, et al. Preoperative platelet/lymphocyte ratio is a superior prognostic factor compared to other systemic inflammatory response markers in ovarian cancer patients[J]. Tumour Biol, 2015, 36(11): 8831-8837.
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