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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11.	買志福, 楊波, 蔡小玲, 等. 血小板與癌癥的研究進展. 現代檢驗醫學雜志, 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.
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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.	閻龍, 戴朝六. 上皮-間質轉化與肝細胞癌炎癥微環境的關系研究. 中國普外基礎與臨床雜志, 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.	夏志剛, 甘志明, 向立歷, 等. NLR和PLR 與結直腸癌患者 TNM 分期及預后的相關性研究. 中國普外基礎與臨床雜志, 2017, 24(8): 963-969.
19.	任莎莎, 簡文, 劉自明. 系統免疫炎癥指數和骨骼肌質量指數與肝硬化合并肝癌患者術后預后的關系. 現代腫瘤醫學, 2020, 28(10): 1693-1697.
20.	劉洪恩, 辛大平, 彭彬. NLR、PLR和SII在肝癌根治術患者中的表達及與預后的相關性. 中國醫師雜志, 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.	潘穎威, 孟翔飛, 周林, 等. 中性粒細胞與淋巴細胞比值在原發性肝癌診斷及預后判斷中的價值. 腫瘤研究與臨床, 2020, 32(3): 157-160.

1. 中華人民共和國國家衛生健康委員會醫政醫管局. 原發性肝癌診療規范(2019年版). 臨床肝膽病雜志, 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. 胡朝輝, 羅華, 楊培, 等. 乙型肝炎病毒基因型與肝細胞肝癌關系的研究. 中國普外基礎與臨床雜志, 2010, 17(12): 1261-1264.
4. 四川大學華西醫院肝癌MDT團隊. 肝細胞肝癌全程多學科規范化管理: 華西醫院多學科專家共識(第二版). 中國普外基礎與臨床雜志, 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. 中性粒細胞與腫瘤的相關性. 臨床與病理雜志, 2020, 40(2): 448-457.
10. 李曉明, 向宗駿, 萬志渝, 等. 外周血炎性指標比值對中晚期食管鱗癌術后復發的預測價值. 中國胸心血管外科臨床雜志, 2019, 26(9): 865-869.
11. 買志福, 楊波, 蔡小玲, 等. 血小板與癌癥的研究進展. 現代檢驗醫學雜志, 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. 葉勁松, 向邦德, 陳能志, 等. 中性粒細胞與淋巴細胞比值預測肝細胞癌患者預后的價值. 中華肝膽外科雜志, 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. 閻龍, 戴朝六. 上皮-間質轉化與肝細胞癌炎癥微環境的關系研究. 中國普外基礎與臨床雜志, 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. 夏志剛, 甘志明, 向立歷, 等. NLR和PLR 與結直腸癌患者 TNM 分期及預后的相關性研究. 中國普外基礎與臨床雜志, 2017, 24(8): 963-969.
19. 任莎莎, 簡文, 劉自明. 系統免疫炎癥指數和骨骼肌質量指數與肝硬化合并肝癌患者術后預后的關系. 現代腫瘤醫學, 2020, 28(10): 1693-1697.
20. 劉洪恩, 辛大平, 彭彬. NLR、PLR和SII在肝癌根治術患者中的表達及與預后的相關性. 中國醫師雜志, 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. 潘穎威, 孟翔飛, 周林, 等. 中性粒細胞與淋巴細胞比值在原發性肝癌診斷及預后判斷中的價值. 腫瘤研究與臨床, 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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