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

doi:10.3877/cma.j.issn.1674-0793.2017.01.004

Abstract

Abstract:

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.

Key words: Carcinoma, hepatocellular, Pathology, clinical, Survival analysis, Platelet-lymphocyte ratio

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.

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URL: https://zhptwkxwx.cma-cmc.com.cn/EN/10.3877/cma.j.issn.1674-0793.2017.01.004

https://zhptwkxwx.cma-cmc.com.cn/EN/Y2017/V11/I01/13

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References 18

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临床病理参数		低PLR组（206例）	高PLR组（186例）	χ²值	P值
年龄（岁）				0.461	0.497
	≤60	132（64.1）	113（60.8）
	>60	74（35.9）	73（39.2）
性别				0.225	0.635
	男	153（74.3）	142（76.3）
	女	53（25.7）	44（23.7）
乙肝或丙肝　病毒感染				4.182	0.041^a
	阴性	53（25.7）	32（17.2）
	阳性	153（74.3）	154（82.8）
肝硬化				1.944	0.163
	有	64（31.1）	46（24.7）
	无	142（68.9）	140（75.3）
AFP（μg/L）				7.222	0.007^a
	>400	85（41.3）	102（54.8）
	≤400	121（58.7）	84（45.2）
肿瘤大小（cm）				4.898	0.027^a
	≤5	90（43.7）	61（32.8）
	>5	116（56.3）	125（67.2）
肿瘤个数				3.069	0.080
	1	162（78.6）	132（71.0）
	>1	44（21.4）	54（29.0）
Child-Pugh分级				2.445	0.118
	A	172（82.7）	142（76.3）
	B+C	36（17.3）	44（23.7）
TNM分期				4.178	0.041^a
	Ⅰ+Ⅱ	111（53.9）	81（43.5）
	Ⅲ+Ⅳ	95（46.1）	105（56.5）

临床病理参数		低PLR组（206例）	高PLR组（186例）	χ²值	P值
年龄（岁）				0.461	0.497
	≤60	132（64.1）	113（60.8）
	>60	74（35.9）	73（39.2）
性别				0.225	0.635
	男	153（74.3）	142（76.3）
	女	53（25.7）	44（23.7）
乙肝或丙肝　病毒感染				4.182	0.041^a
	阴性	53（25.7）	32（17.2）
	阳性	153（74.3）	154（82.8）
肝硬化				1.944	0.163
	有	64（31.1）	46（24.7）
	无	142（68.9）	140（75.3）
AFP（μg/L）				7.222	0.007^a
	>400	85（41.3）	102（54.8）
	≤400	121（58.7）	84（45.2）
肿瘤大小（cm）				4.898	0.027^a
	≤5	90（43.7）	61（32.8）
	>5	116（56.3）	125（67.2）
肿瘤个数				3.069	0.080
	1	162（78.6）	132（71.0）
	>1	44（21.4）	54（29.0）
Child-Pugh分级				2.445	0.118
	A	172（82.7）	142（76.3）
	B+C	36（17.3）	44（23.7）
TNM分期				4.178	0.041^a
	Ⅰ+Ⅱ	111（53.9）	81（43.5）
	Ⅲ+Ⅳ	95（46.1）	105（56.5）

参数	Wald值	相对危险度（RR）	95% CI	P值
年龄	0.017	-	-	0.896
性别	18.826	1.874	1.411~2.489	<0.001
乙型或丙型肝炎	2.194	-	-	0.139
肝硬化	1.945	-	-	0.163
AFP水平	7.610	1.031	1.009~1.054	0.006
肿瘤大小	5.374	1.179	1.026~1.355	0.020
肿瘤个数	22.178	1.493	1.264~1.764	<0.001
Child-Pugh分级	0.070	-	-	0.792
TNM分级	21.918	1.272	1.150~1.406	<0.001
PLR水平	21.393	1.771	1.390~2.256	<0.001

参数	Wald值	相对危险度（RR）	95% CI	P值
年龄	0.017	-	-	0.896
性别	18.826	1.874	1.411~2.489	<0.001
乙型或丙型肝炎	2.194	-	-	0.139
肝硬化	1.945	-	-	0.163
AFP水平	7.610	1.031	1.009~1.054	0.006
肿瘤大小	5.374	1.179	1.026~1.355	0.020
肿瘤个数	22.178	1.493	1.264~1.764	<0.001
Child-Pugh分级	0.070	-	-	0.792
TNM分级	21.918	1.272	1.150~1.406	<0.001
PLR水平	21.393	1.771	1.390~2.256	<0.001

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