Value of neutrophil-to-lymphocyte ratio in the diagnosis and prognosis evaluation of primary hepatocellular carcinoma

Yingwei Pan, XiangFei Meng, Lingyue Zhou, Zhiqiang Wang, Hangyu Zhang, Shi-xin Lu
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Abstract

Objective To investigate the value of neutrophil-to-lymphocyte ratio (NLR) in the diagnosis and prognosis evaluation of primary hepatocellular carcinoma. Methods The clinical data of 100 patients pathologically diagnosed as primary liver cancer who were admitted to the First Medical Center of Chinese PLA General Hospital from January 2013 to December 2015 were retrospectively analyzed. Serum alpha fetoprotein (AFP), a conventional marker for hepatocellular carcinoma diagnosis was used as the control. The fourfold table diagnostic test was applied to analyze the sensitivity and specificity of serum NLR in the diagnosis of hepatocellular carcinoma, and the correlation with the degree of tumor differentiation was also analyzed. Results The proportion of patients with high NLR (≥1.70) [56% (56/100)] was higher than the proportion of patients with positive AFP [44% (44/100)] in all 100 hepatocellular carcinoma patients, but the difference was not statistically significant (χ2 = 2.88, P = 0.08). Among AFP-positive patients, the median survival time of patients with low and high NLR was 59 and 48 months, respectively, and the difference was statistically significant (χ2 = 3.91, P = 0.048), and high NLR was an independent risk factor affecting the prognosis of hepatocellular carcinoma patients (HR = 1.232, 95% CI 1.055-1.438, P = 0.008). Conclusions The detection of NLR combined with AFP can improve the diagnostic rate of hepatocellular carcinoma before surgery. High NLR is an independent risk factor affecting the prognosis of patients with primary hepatocellular carcinoma. Key words: Liver neoplasms; Neutrophil-to-lymphocyte ratio; Diagnosis; Prognosis
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中性粒细胞与淋巴细胞比值在原发性肝细胞癌诊断及预后评价中的价值
目的探讨中性粒细胞与淋巴细胞比值(NLR)在原发性肝癌诊断及预后评价中的价值。方法回顾性分析2013年1月至2015年12月解放军总医院第一医疗中心收治的100例经病理诊断为原发性肝癌患者的临床资料。血清甲胎蛋白(AFP)作为肝细胞癌诊断的常规标志物作为对照。应用四重表诊断试验分析血清NLR对肝细胞癌诊断的敏感性和特异性,并分析其与肿瘤分化程度的相关性。结果100例肝癌患者中,高NLR(≥1.70)患者比例[56%(56/100)]高于AFP阳性患者比例[44%(44/100)],但差异无统计学意义(χ2 = 2.88, P = 0.08)。在afp阳性患者中,低NLR和高NLR患者的中位生存时间分别为59个月和48个月,差异有统计学意义(χ2 = 3.91, P = 0.048),高NLR是影响肝细胞癌患者预后的独立危险因素(HR = 1.232, 95% CI 1.055 ~ 1.438, P = 0.008)。结论术前联合AFP检测NLR可提高肝癌的诊断率。高NLR是影响原发性肝癌患者预后的独立危险因素。关键词:肝脏肿瘤;Neutrophil-to-lymphocyte比率;诊断;预后
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肿瘤研究与临床
肿瘤研究与临床 Medicine-Oncology
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