A novel and accurate predictor of survival for patients with hepatocellular carcinoma after surgical resection: the neutrophil to lymphocyte ratio (NLR) combined with the aspartate aminotransferase/platelet count ratio index (APRI)

BMC Cancer

Research Article

Yao Liang¹  Shun-Li Shen²  Yun-Peng Hua²  Bao-Gang Peng²  Li-Jian Liang²  Shao-Qiang Li²  Man Shu³  Fei Ji⁴  Shun-Jun Fu⁴  Zhi-Yong Guo⁴ 

[1] Department of Gastric and Pancreatic Surgery, Sun Yat-sen University Cancer Center, 510060, Guangzhou, PR China;Department of Liver Surgery, the First Affiliated Hospital, Sun Yat-sen University, 510080, Guangzhou, PR China;Department of Pathology, the First Affiliated Hospital, Sun Yat-sen University, 510080, Guangzhou, PR China;Organ Transplant Center, the First Affiliated Hospital, Sun Yat-sen University, 510080, Guangzhou, PR China;

关键词: Neutrophil to lymphocyte ratio;    Aspartate aminotransferase/platelet count ratio index;    Hepatocellular carcinoma;    Prognosis;    Biomarkers;   

DOI  :  10.1186/s12885-016-2189-1

 received in 2015-08-05, accepted in 2016-02-16,  发布年份 2016

来源: Springer

【 摘 要 】

BackgroundThe occurrence and development of hepatocellular carcinoma (HCC) depends largely on such non-tumor factors as inflammatory condition, immune state, viral infection and liver fibrosis. Various inflammation-based prognostic scores have been associated with survival in patients with HCC, such as the neutrophil/lymphocyte ratio (NLR), the platelet/lymphocyte ratio (PLR) and the prognostic nutritional index (PNI). The aspartate aminotransferase/platelet count ratio index (APRI) is thought to be a biomarker of liver fibrosis and cirrhosis. This study aims to evaluate the ability of these indices to predict survival in HCC patients after curative hepatectomy, and probe the increased prognostic accuracy of APRI combined with established inflammation-based prognostic scores.MethodsData were collected retrospectively from 321 patients who underwent curative resection for HCC. Preoperative NLR, PLR, PNI, APRI and clinico-pathological variables were analyzed. Univariate and multivariate analyses were performed to identify the predictive value of the above factors for disease-free survival (DFS) and overall survival (OS).ResultsUnivariate analysis showed that NLR, PLR, PNI and APRI were significantly associated with DFS and OS in HCC patients with curative resection. Multivariate analysis showed that NLR and APRI were superior to PLR and PNI, and both were independently correlated with DFS and OS. Preoperative NLR >2 or APRI >1.68 predicted poor prognosis of patients with HCC after hepatectomy. Furthermore, the predictive range of NLR combined with APRI was more sensitive than that of either measure alone.ConclusionsPreoperative NLR and APRI are independent predictors of DFS and OS in patients with HCC after surgical resection. Higher levels of NLR or APRI predict poorer outcomes in HCC patients. Intriguingly, combining NLR and APRI increases the prognostic accuracy of testing.

【 授权许可】

CC BY   
© Ji et al. 2016