The value of neutrophil to lymphocyte ratio combined with systemic immune inflammation index in evaluating the prognosis of hepatitis B-related hepatocellular carcinoma after hepatectomy_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

SI Ying ¹ , XIAO Ke ¹ , SUN Changfeng ¹ , SUN Bo ² ,  HUANG Yongmao ¹

1. Department of Infectious Diseases, Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan 646000, P. R. China;
2. Department of Hepatobiliary Surgery, Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan 646000, P. R. China;

Corresponding author：

HUANG Yongmao, Email: huang5616@sina.com

Keywords：

hepatitis B-related hepatocellular carcinoma; hepatectomy; prognosis; neutrophil to lymphocyte ratio; systemic immune inflammatory index; prediction

DOI：

10.7507/1007-9424.202010044

Video：

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Objective To explore the combined application of neutrophil to lymphocyte ratio (NLR) and systemic immune inflammation index (SII) on the prognosis of hepatitis B-related hepatocellular carcinoma after resection.Methods Retrospectively collected data of 180 patients with hepatitis B-related hepatocellular carcinoma who were hospitalized in the Department of Infectious Diseases and Hepatobiliary Surgery of the Affiliated Hospital of Southwest Medical University and received surgical treatment from January 2013 to December 2019, including general information, laboratory examination and abdominal CT or MRI results. NLR and SII values were measured at one week before operation, and their critical values of NLR and SII were determined by ROC curve analysis. Univariate and multivariate analysis were performed to determine the risk factors to predict the survival status of patients with hepatitis B-related hepatocellular carcinoma after hepatectomy.Results Univariate analysis showed that AFP, platelets, TNM staging, portal vein tumor thrombus, tumor differentiation, NLR, SII, and NLR+SII combined score were significantly correlated with the prognosis of patients with hepatitis B-related hepatocellular carcinoma (P<0.05). Multivariate analysis showed that PLT [HR=1.791, 95%CI (1.124, 2.854), P=0.014], NLR [HR=4.289, 95%CI (2.571, 7.156), P<0.001], SII [HR=5.317, 95%CI (3.016, 9.374), P<0.001], and NLR+SII combined score [HR=7.901, 95%CI (4.124, 15.138), P<0.001] were independently correlated with the survival of patients with hepatitis B-related hepatocellular carcinoma.Conclusions The preoperative NLR+SII combined score can be used to evaluate the postoperative prognosis of patients with hepatitis B-related hepatocellular carcinoma. The higher the score, the lower the postoperative survival rate.

Citation： SI Ying, XIAO Ke, SUN Changfeng, SUN Bo, HUANG Yongmao. The value of neutrophil to lymphocyte ratio combined with systemic immune inflammation index in evaluating the prognosis of hepatitis B-related hepatocellular carcinoma after hepatectomy. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2021, 28(8): 1056-1061. doi: 10.7507/1007-9424.202010044 Copy

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14.	叶劲松, 向邦德, 陈能志, 等. 中性粒细胞与淋巴细胞比值预测肝细胞癌患者预后的价值. 中华肝胆外科杂志, 2017, 23(3): 158-161.
15.	Xu L, Yu S, Zhuang L, et al. Systemic inflammation response index (SIRI) predicts prognosis in hepatocellular carcinoma patients. Oncotarget, 2017, 8(21): 34954-34960.
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17.	Franz L, Alessandrini L, Fasanaro E, et al. Prognostic impact of neutrophils-to-lymphocytes ratio (NLR), PD-L1 expression, and tumor immune microenvironment in laryngeal cancer. Ann Diagn Pathol, 2020, 50: 151657.
18.	夏志刚, 甘志明, 向立历, 等. NLR和PLR 与结直肠癌患者 TNM 分期及预后的相关性研究. 中国普外基础与临床杂志, 2017, 24(8): 963-969.
19.	任莎莎, 简文, 刘自明. 系统免疫炎症指数和骨骼肌质量指数与肝硬化合并肝癌患者术后预后的关系. 现代肿瘤医学, 2020, 28(10): 1693-1697.
20.	刘洪恩, 辛大平, 彭彬. NLR、PLR和SII在肝癌根治术患者中的表达及与预后的相关性. 中国医师杂志, 2020, 22(9): 1352-1355.
21.	Mouchli M, Reddy S, Gerrard M, et al. Usefulness of neutrophil-to-lymphocyte ratio (NLR) as a prognostic predictor after treatment of hepatocellular carcinoma. Review article. Ann Hepatol, 2020, 22: 100249.
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1. 中华人民共和国国家卫生健康委员会医政医管局. 原发性肝癌诊疗规范(2019年版). 临床肝胆病杂志, 2020, 36(2): 277-292.
2. Abd-Elsalam S, Elwan N, Soliman H, et al. Epidemiology of liver cancer in Nile delta over a decade: A single-center study. South Asian J Cancer, 2018, 7(1): 24-26.
3. 胡朝辉, 罗华, 杨培, 等. 乙型肝炎病毒基因型与肝细胞肝癌关系的研究. 中国普外基础与临床杂志, 2010, 17(12): 1261-1264.
4. 四川大学华西医院肝癌MDT团队. 肝细胞肝癌全程多学科规范化管理: 华西医院多学科专家共识(第二版). 中国普外基础与临床杂志, 2020, 27(9): 1062-1077.
5. Barsouk A, Thandra KC, Saginala K, et al. Chemical risk factors of primary liver cancer: an update. Hepat Med, 2021, 12: 179-188.
6. Michels N, van Aart C, Morisse J, et al. Chronic inflammation towards cancer incidence: A systematic review and meta-analysis of epidemiological studies. Crit Rev Oncol Hematol, 2021, 157: 103177.
7. Lemaire J, Larrue R, Perrais M, et al. Fundamental aspects of oncogenesis. Bull Cancer, 2020, 107(11): 1148-1160.
8. Smith HA, Kang Y. The metastasis-promoting roles of tumor-associated immune cells. J Mol Med (Berl), 2013, 91(4): 411-429.
9. 商安全, 李冬. 中性粒细胞与肿瘤的相关性. 临床与病理杂志, 2020, 40(2): 448-457.
10. 李晓明, 向宗骏, 万志渝, 等. 外周血炎性指标比值对中晚期食管鳞癌术后复发的预测价值. 中国胸心血管外科临床杂志, 2019, 26(9): 865-869.
11. 买志福, 杨波, 蔡小玲, 等. 血小板与癌症的研究进展. 现代检验医学杂志, 2018, 33(5): 161-164.
12. Yang HJ, Guo Z, Yang YT, et al. Blood neutrophil-lymphocyte ratio predicts survival after hepatectomy for hepatocellular carcinoma: A propensity score-based analysis. World J Gastroenterol, 2016, 22(21): 5088-5095.
13. 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. Oncotarget, 2015, 6(40): 43090-43098.
14. 叶劲松, 向邦德, 陈能志, 等. 中性粒细胞与淋巴细胞比值预测肝细胞癌患者预后的价值. 中华肝胆外科杂志, 2017, 23(3): 158-161.
15. Xu L, Yu S, Zhuang L, et al. Systemic inflammation response index (SIRI) predicts prognosis in hepatocellular carcinoma patients. Oncotarget, 2017, 8(21): 34954-34960.
16. 阎龙, 戴朝六. 上皮-间质转化与肝细胞癌炎症微环境的关系研究. 中国普外基础与临床杂志, 2017, 24(7): 885-889.
17. Franz L, Alessandrini L, Fasanaro E, et al. Prognostic impact of neutrophils-to-lymphocytes ratio (NLR), PD-L1 expression, and tumor immune microenvironment in laryngeal cancer. Ann Diagn Pathol, 2020, 50: 151657.
18. 夏志刚, 甘志明, 向立历, 等. NLR和PLR 与结直肠癌患者 TNM 分期及预后的相关性研究. 中国普外基础与临床杂志, 2017, 24(8): 963-969.
19. 任莎莎, 简文, 刘自明. 系统免疫炎症指数和骨骼肌质量指数与肝硬化合并肝癌患者术后预后的关系. 现代肿瘤医学, 2020, 28(10): 1693-1697.
20. 刘洪恩, 辛大平, 彭彬. NLR、PLR和SII在肝癌根治术患者中的表达及与预后的相关性. 中国医师杂志, 2020, 22(9): 1352-1355.
21. Mouchli M, Reddy S, Gerrard M, et al. Usefulness of neutrophil-to-lymphocyte ratio (NLR) as a prognostic predictor after treatment of hepatocellular carcinoma. Review article. Ann Hepatol, 2020, 22: 100249.
22. 潘颖威, 孟翔飞, 周林, 等. 中性粒细胞与淋巴细胞比值在原发性肝癌诊断及预后判断中的价值. 肿瘤研究与临床, 2020, 32(3): 157-160.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

The value of neutrophil to lymphocyte ratio combined with systemic immune inflammation index in evaluating the prognosis of hepatitis B-related hepatocellular carcinoma after hepatectomy

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