肝动脉介入灌注化疗/栓塞术前中性粒细胞与淋巴细胞比值对原发性肝癌患者预后的影响

目的:探讨原发性肝癌（PHC）患者术前中性粒细胞/淋巴细胞比值（NLR）对预后的影响。方法:回顾性分析96例行经导管肝动脉栓塞化疗(TACE）术的PHC患者临床病理资料。根据术前NLR值，分为低NLR组（NLR<2.5）和高NLR组（NLR≥2.5），分析两组患者总生存时间与无进展生存时间；并对其影响预后的危险因素行单因素与多因素分析。结果:全组介入术后，中位总生存时间21.1个月；其中术前高NLR组中位总生存时间16.0个月；术前低NLR组中位总生存时间 23.3个月；两组中位生存时间差异有统计学意义（P=0.002)。全组患者中位无进展生存时间13.8个月，其中高NLR组中位无进展生存时间 9.6个月，低NLR组中位无进展生存时间17.6个月，两组中位无进展生存时间差异有统计学意义（P=0.011）。单因素分析显示:肝功能Child分级、BCLC分期、AFP、假包膜形成、血供、TACE次数、NLR≥2.5 是影响PHC患者TACE术后总生存时间的危险因素（P<0.05）。肝功能Child分级、BCLC分期、假包膜形成、血供、NLR≥2.5是影响PHC患者TACE术后无进展生存时间的危险因素（P<0.05）；多因素分析显示，肝功能Child分级、BCLC分期、NLR≥2.5是影响PHC患者TACE术后生存的独立预后因素（P<0.05）。BCLC分期、NLR≥2.5是影响PHC患者TACE术后无进展生存时间的独立预后因素（P<0.05）。结论:术前外周血NLR可作为PHC患者行TACE的预后指标，NLR高者预后差。

Impact of preoperative peripheral blood neutrophil - to - lymphocyte ratio on prognosis of liver cancer patients undergoing transcatheter arterial chemoembolization

Objective:To investigate the impact of the preoperative peripheral blood neutrophil-to-lymphocyte ratio (NLR) on postoperative prognosis of patients with primary hepatic cancer (PHC).Methods:Clinicopathologic data of 96 PHC patients undergoing transcatheter arterial chemoembolization (TACE) were analyzed retrospectively.Based on the preoperative neutrophil-to-lymphocyte ratio (NLR)，the patients were divided into low NLR group (NLR<2.5) and high NLR (NLR≥2.5) group.The overall survival time and progress-free survival time of the two groups were analyzed，and risk factors that would influence the prognosis of these patients were determined by univariate and multivariate analyses.Results:The median overall survival time for the entire group was 21.1 months，which for high NLR group and low NLR group was 16.0 and 23.3 respectively.The difference in the overall survival between the two groups had statistical significance (P=0.002).The median progress free survival time for the entire group was 13.8 months，which for high NLR group and low NLR group was 9.6 and 17.6，and there was statistically significant difference in the progression-free survival time between the two groups (P=0.011).Univariate analysis showed that liver function Child classification，BCLC staging，AFP，formation of psuedocapsule，blood supply，frequency of TACE and NLR≥2.5 were the risk factors for the postoperative overall survival time of PHC patients undergoing TACE (P<0.05)，and liver function Child classification，BCLC staging，formation of psuedocapsule，blood supply and NLR≥2.5 were the risk factors for the postoperative progress-free time of PHC patients undergoing TACE (P<0.05).Multivariate analysis revealed that liver function Child classification，BCLC staging and NLR≥2.5 were the independent prognostic factors for the survival of PHC patients undergoing TACE (all P<0.05)，and BCLC staging and NLR≥2.5 were the independent prognostic factors for postoperative progress-free time of PHC patients undergoing TACE (P<0.05).Conclusion:Preoperative peripheral blood NLR can be used as a prognostic predictor of PHC patients undergoing TACE，and those with high NLR face a poor prognosis.