High Neutrophil–Lymphocyte Ratio and Delta Neutrophil–Lymphocyte Ratio Are Associated with Increased Mortality in Patients with Hepatocellular Cancer
| Autor: | Amit G. Singal, Ana B. Arroyo, Nicole E. Rich, Marlyn J. Mayo, Hao Zhu, Arjmand R. Mufti, Yujin Hoshida, Takeshi Yokoo, Shannan R. Tujios, Thomas A. Kerr, Adam C. Yopp, Ju Dong Yang, Aarthi Parvathaneni, Jorge A. Marrero, Ahana Sen, William M. Lee, Mobolaji Odewole, Lafaine Grant, Purva Gopal |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
Cirrhosis Physiology business.industry Lymphocyte fungi Gastroenterology Retrospective cohort study Hepatology medicine.disease 03 medical and health sciences 0302 clinical medicine medicine.anatomical_structure 030220 oncology & carcinogenesis Hepatocellular carcinoma Internal medicine Cohort medicine Biomarker (medicine) 030211 gastroenterology & hepatology Liver cancer business |
| Zdroj: | Digestive Diseases and Sciences. 67:2666-2676 |
| ISSN: | 1573-2568 0163-2116 |
| Popis: | The neutrophil–lymphocyte ratio (NLR) has been proposed as a prognostic biomarker for cirrhosis and non-liver malignancies. We aimed to evaluate the prognostic value of NLR in a diverse cohort of patients with hepatocellular carcinoma (HCC). We performed a retrospective study of patients diagnosed with HCC between 2008 and 2017 at two large US health systems. We used Cox proportional hazard and multivariable ordinal logistic regression models to identify factors associated with overall survival and response to first HCC treatment, respectively. Primary variables of interest were baseline NLR and delta NLR, defined as the difference between pre- and post-treatment NLR. Among 1019 HCC patients, baseline NLR was 200 ng/mL (45.6% vs 33.8%). Baseline NLR ≥ 5 was independently associated with higher mortality (median survival 4.3 vs 15.1 months; adjusted HR 1.70, 95%CI 1.41–2.06), with differences in survival consistent across BCLC stages. After adjusting for baseline covariates including NLR, delta NLR > 0.26 was also independently associated with increased mortality (HR 1.42, 95%CI 1.14–1.78). In a secondary analysis, high NLR was associated with lower odds of response to HCC treatment (20.2% vs 31.6%; adjusted OR 0.55, 95%CI 0.32–0.95). In a large Western cohort of patients with HCC, high baseline NLR and delta NLR were independent predictors of mortality. NLR is an inexpensive test that may be a useful component of future HCC prognostic models. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Full text from SpringerLink