scholarly journals Prognostic value of preoperative inflammatory markers in patients with hepatocellular carcinoma underwent curative resection

2021 ◽  
Author(s):  
Wenlong Wu ◽  
Quancheng Wang ◽  
Dandan Han ◽  
Jianhui Li ◽  
Ye Nie ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Prognostic Factors ◽  
Inflammatory Markers ◽  
Curative Resection ◽  
Information Criterion ◽  
Gamma Glutamyl Transpeptidase ◽  
Roc Curve Analysis ◽  
Lymphocyte Ratio ◽  
Kaplan Meier ◽  
Glutamyl Transpeptidase

Abstract Background: The prognosis of hepatocellular carcinoma (HCC) is not optimistic. Our study focused on present inflammatory markers, including neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), gamma-glutamyl transpeptidase-to-platelet ratio (GPR), aspartate aminotransferase-to-lymphocyte ratio (ALR) and fibrinogen-to-albumin ratio (FAR), and aimed to explore their optimal combination for the prognosis of HCC after resection.Methods: 347 HCC patients with curative resection were enrolled. The optimal cutoff values of the inflammatory markers were calculated using receiver operating characteristic (ROC) curve analysis, and used to divide patients into two groups whose differences were compared by Kaplan-Meier analysis. Cox univariate and multivariate analysis were used to analyze the independent prognostic inflammatory markers. c2 test was chosen to determine the relationship between independent prognostic inflammatory markers and clinicopathological features. We created the combined scoring models and evaluated them by Cox univariate and multivariate methods. The concordance index (C-index), Akaike information criterion (AIC) and likelihood ratio were calculated to compare the models. The selected optimal inflammatory markers and their combinations were tested in different stages of HCC by Kaplan-Meier analysis.Results: ALR and GPR were independent prognostic factors for DFS; ALR, PLR, and GPR were independent prognostic factors for OS. The proposed GPR and ALR-GPR-PLR score models were independent predictors for DFS and OS, respectively.Conclusion: The preoperative GPR and ALR-GPR-PLR score models were independent predictors for DFS and OS, respectively, and performed well in stratifying patients with HCC. The higher score in the model, the worse the prognosis was.

scholarly journals Prognostic value of preoperative inflammatory markers in patients with hepatocellular carcinoma who underwent curative resection

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Wenlong Wu ◽  
Quancheng Wang ◽  
Dandan Han ◽  
Jianhui Li ◽  
Ye Nie ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Prognostic Factors ◽  
Inflammatory Markers ◽  
Curative Resection ◽  
Disease Free Survival ◽  
Information Criterion ◽  
Gamma Glutamyl Transpeptidase ◽  
Roc Curve Analysis ◽  
Lymphocyte Ratio ◽  
Kaplan Meier

Abstract Background The prognosis of hepatocellular carcinoma (HCC) is not optimistic. Our study focused on present inflammatory markers, including the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), gamma-glutamyl transpeptidase-to-platelet ratio (GPR), aspartate aminotransferase-to-lymphocyte ratio (ALR) and fibrinogen-to-albumin ratio (FAR), and explored their optimal combination for the prognosis of HCC after resection. Methods A total of 347 HCC patients who underwent curative resection were enrolled. The optimal cutoff values of the inflammatory markers were calculated using receiver operating characteristic (ROC) curve analysis, and used to divide patients into two groups whose differences were compared by Kaplan–Meier analysis. Cox univariate and multivariate analyses were used to analyze the independent prognostic inflammatory markers. The χ2 test was chosen to determine the relationship between independent prognostic inflammatory markers and clinicopathological features. We created combined scoring models and evaluated them by Cox univariate and multivariate methods. The concordance index (C-index), Akaike information criterion (AIC) and likelihood ratio were calculated to compare the models. The selected optimal inflammatory markers and their combinations were tested in different stages of HCC by Kaplan–Meier analysis. Results The ALR and GPR were independent prognostic factors for disease-free survival (DFS); the ALR, PLR, and GPR were independent prognostic factors for overall survival (OS). The proposed GPR and ALR-GPR-PLR score models were independent predictors for DFS and OS, respectively. Conclusion The preoperative GPR and ALR-GPR-PLR score models were independent predictors for DFS and OS, respectively, and performed well in stratifying patients with HCC. The higher the score in the model was, the worse the prognosis.

scholarly journals AGLR is a Novel Index for the Prognosis of Hepatocellular Carcinoma Patients: A Retrospective Study

2020 ◽  
Author(s):  
Yan Liao ◽  
Rongyu Wei ◽  
Renzhi Yao ◽  
Liling Qin ◽  
Jun Li ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Roc Curve ◽  
Validation Cohort ◽  
Multivariate Analyses ◽  
The Novel ◽  
Gamma Glutamyl Transpeptidase ◽  
Roc Curve Analysis ◽  
Training Cohort ◽  
Scoring Model ◽  
Kaplan Meier

Abstract Background: Most hepatocellular carcinoma (HCC) patients’ liver function indexes are abnormal. We aimed to investigate the relationship between (alkaline phosphatase + gamma-glutamyl transpeptidase) / lymphocyte ratio (AGLR) and the progression as well as the prognosis of HCC. Methods: A total of 495 HCC patients undergoing radical hepatectomy were retrospectively analyzed. We randomly divided these patients into the training cohort (n = 248) and the validation cohort (n = 247). In the training cohort, receiver operating characteristic (ROC) curve was used to determine the optimal cut-off value of AGLR for predicting postoperative survival of HCC patients, and the predictive value of AGLR was evaluated by concordance index (C-index). Further analysis of clinical and biochemical data of patients and the correlation analysis between AGLR and other clinicopathological factors were finished. Univariate and multivariate analyses were performed to identify prognostic factors for HCC patients. Survival curves were analyzed using the Kaplan-Meier method.Results: According to the ROC curve analysis, the optimal predictive cut-off value of AGLR was 90. The C-index of AGLR was 0.637 in the training cohort and 0.654 in the validation cohort, respectively. Based on this value, the HCC patients were divided into the low-AGLR group (AGLR ≤ 90) and the high-AGLR group (AGLR > 90). Preoperative AGLR level was positively correlated with α-fetoprotein (AFP), tumor size, tumor-node-metastasis (TNM) stage, and microvascular invasion (MVI) (all p < 0.05). In the training and validation cohorts, patients with AGLR > 90 had significantly shorter OS than patients with AGLR ≤ 90 (p < 0.001). Univariate and multivariate analyses of the training cohort (HR, 1.79; 95% CI, 1.21-2.69; p < 0.001) and validation cohort (HR, 1.82; 95% CI, 1.35-2.57; p < 0.001) had identified AGLR as an independent prognostic factor. A new prognostic scoring model was established based on the independent predictors determined in multivariate analysis.Conclusions: The elevated preoperative AGLR level indicated poor prognosis for patients with HCC; the novel prognostic scoring model had favorable predictive capability for postoperative prognosis of HCC patients, which may bring convenience for clinical management.

scholarly journals Preoperative Neutrophil-to-Lymphocyte Ratio Plus Platelet-to-Lymphocyte Ratio Predicts the Outcomes after Curative Resection for Hepatocellular Carcinoma

2019 ◽  
Vol 2019 ◽  
pp. 1-9 ◽  
Author(s):  
T. Kabir ◽  
M. Ye ◽  
N. A. Mohd Noor ◽  
W. Woon ◽  
S. P. Junnarkar ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Liver Resection ◽  
Curative Resection ◽  
Scoring Systems ◽  
Neutrophil To Lymphocyte Ratio ◽  
Platelet To Lymphocyte Ratio ◽  
Roc Curve Analysis ◽  
Curative Intent ◽  
Lymphocyte Ratio

Background. In recent years, inflammation-based scoring systems have been reported to predict survival in Hepatocellular Carcinoma (HCC). The aim of our study was to validate combined preoperative Neutrophil-to-Lymphocyte ratio (NLR)-Platelet-to-Lymphocyte ratio (PLR) in predicting overall survival (OS) and recurrence free survival (RFS) in patients who underwent curative resection for HCC. Methods. We conducted a retrospective study of HCC patients underwent liver resection with curative intent from January 2010 to December 2013. Receiver-operating characteristic (ROC) curve analysis was used to determine the optimal cut-off values for NLR and PLR. Patients with both NLR and PLR elevated were allocated a score of 2; patients showing one or neither of these indices elevated were accorded a score of 1 or 0, respectively. Results. 132 patients with a median age of 66 years (range 18-87) underwent curative resection for HCC. Overall morbidity was 30.3%, 30-day mortality was 2.3%, and 90-day mortality was 6.8%. At a median follow-up of 24 months (range 1-88), 25% patients died, and 40.9% had recurrence. On multivariate analysis, elevated preoperative NLR-PLR was predictive of both OS (HR 2.496; CI 1.156-5.389; p=0.020) and RFS (HR 1.917; CI 1.161-3.166; p=0.011). The 5-year OS was 76% for NLR-PLR=0 group, 21.7% for the NLR-PLR=1 group, and 61.1% for the NLR-PLR=2 group, respectively. The 5-year RFS was 39.3% for the NLR-PLR=0 group, 18.4% for the NLR-PLR=1 group, and 21.1% for the NLR-PLR=2 group, respectively. Conclusion. The preoperative NLR-PLR is predictive of both OS and RFS in patients with HCC undergoing curative liver resection.

scholarly journals AGLR is a novel index for the prognosis of hepatocellular carcinoma patients: a retrospective study

BMC Surgery ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Yan Liao ◽  
Rongyu Wei ◽  
Renzhi Yao ◽  
Liling Qin ◽  
Jun Li ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Roc Curve ◽  
Validation Cohort ◽  
Multivariate Analyses ◽  
The Novel ◽  
Gamma Glutamyl Transpeptidase ◽  
Roc Curve Analysis ◽  
Training Cohort ◽  
Scoring Model ◽  
Kaplan Meier

Abstract Background Most hepatocellular carcinoma (HCC) patients’ liver function indexes are abnormal. We aimed to investigate the relationship between (alkaline phosphatase + gamma-glutamyl transpeptidase)/lymphocyte ratio (AGLR) and the progression as well as the prognosis of HCC. Methods A total of 495 HCC patients undergoing radical hepatectomy were retrospectively analyzed. We randomly divided these patients into the training cohort (n = 248) and the validation cohort (n = 247). In the training cohort, receiver operating characteristic (ROC) curve was used to determine the optimal cut-off value of AGLR for predicting postoperative survival of HCC patients, and the predictive value of AGLR was evaluated by concordance index (C-index). Further analysis of clinical and biochemical data of patients and the correlation analysis between AGLR and other clinicopathological factors were finished. Univariate and multivariate analyses were performed to identify prognostic factors for HCC patients. Survival curves were analyzed using the Kaplan–Meier method. Results According to the ROC curve analysis, the optimal predictive cut-off value of AGLR was 90. The C-index of AGLR was 0.637 in the training cohort and 0.654 in the validation cohort, respectively. Based on this value, the HCC patients were divided into the low-AGLR group (AGLR ≤ 90) and the high-AGLR group (AGLR > 90). Preoperative AGLR level was positively correlated with alpha-fetoprotein (AFP), tumor size, tumor-node-metastasis (TNM) stage, and microvascular invasion (MVI) (all p < 0.05). In the training and validation cohorts, patients with AGLR > 90 had significantly shorter OS than patients with AGLR ≤ 90 (p < 0.001). Univariate and multivariate analyses of the training cohort (HR, 1.79; 95% CI 1.21–2.69; p < 0.001) and validation cohort (HR, 1.82; 95% CI 1.35–2.57; p < 0.001) had identified AGLR as an independent prognostic factor. A new prognostic scoring model was established based on the independent predictors determined in multivariate analysis. Conclusions The elevated preoperative AGLR level indicated poor prognosis for patients with HCC; the novel prognostic scoring model had favorable predictive capability for postoperative prognosis of HCC patients, which may bring convenience for clinical management.

scholarly journals Preoperative inflammatory markers of NLR and PLR as indicators of poor prognosis in resectable HCC

PeerJ ◽  
2019 ◽  
Vol 7 ◽  
pp. e7132 ◽  
Author(s):  
Dong Wang ◽  
Ning Bai ◽  
Xi Hu ◽  
Xi Wu OuYang ◽  
Lei Yao ◽  
...  
Keyword(s):  
Prognostic Factors ◽  
Liver Resection ◽  
Inflammatory Markers ◽  
Cox Regression ◽  
Cancer Prognosis ◽  
Cox Regression Analysis ◽  
Lymphocyte Ratio ◽  
Kaplan Meier ◽  
Tumor Number ◽  
Cell Propagation

Background Many recent studies have demonstrated the predominant role chronic inflammation plays in cancer cell propagation, angiogenesis and immunosuppression. Cancer-related inflammation (CRI) has been shown to correlate with poor cancer prognosis. Our study aimed to evaluate the prognostic value of the neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) in patients with hepatocellular carcinoma (HCC) who have undergone liver resection. Methods Between 2012 and 2015, 239 patients with HCC who had undergone liver resection at XiangYa Hospital Central South University were included in this study. The values of simple inflammatory markers, including the NLR and PLR, used in predicting the long-term outcomes of these patients were evaluated using Kaplan–Meier curves and Cox regression models. Results The cutoff values of the NLR and PLR were 2.92 and 128.1, respectively. In multivariate Cox regression analysis, high NLR (≥2.92) and high PLR (≥128.1) were independent risk factors predicting poorer outcomes in patients with HCC. However, high NLR and high PLR were prognostic factors in tumor size and tumor number. Conclusions In this study, we identified that high NLR (≥2.92) and high PLR (≥128.1) are useful prognostic factors in predicting outcomes in patients with HCC whom underwent liver resection.

scholarly journals Transitions of Liver and Biliary Enzymes during Proton Beam Therapy for Hepatocellular Carcinoma

Cancers ◽  
2020 ◽  
Vol 12 (7) ◽  
pp. 1840
Author(s):  
Taisuke Sumiya ◽  
Masashi Mizumoto ◽  
Yoshiko Oshiro ◽  
Keiichiro Baba ◽  
Motohiro Murakami ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Proton Beam ◽  
Liver Damage ◽  
Bragg Peak ◽  
Total Bilirubin ◽  
Normal Liver ◽  
Proton Beam Therapy ◽  
Gamma Glutamyl Transpeptidase ◽  
Preserve Liver Function ◽  
Glutamyl Transpeptidase

Proton beam therapy (PBT) is a curative treatment for hepatocellular carcinoma (HCC), because it can preserve liver function due to dose targeting via the Bragg peak. However, the degree of direct liver damage by PBT is unclear. In this study, we retrospectively analyzed liver/biliary enzymes and total bilirubin (T-Bil) as markers of direct liver damage during and early after PBT in 300 patients. The levels of these enzymes and bilirubin were almost stable throughout the treatment period. In patients with normal pretreatment levels, aminotransferase (AST), alanine aminotransferase (ALT), alkaline phosphatase (ALP), gamma-glutamyl transpeptidase (GGT), and T-Bil were abnormally elevated in only 2 (1.2%), 1 (0.4%), 0, 2 (1.2%), and 8 (3.5%) patients, respectively, and in 8 of these 13 patients (61.5%) the elevations were temporary. In patients with abnormal pretreatment levels, the levels tended to decrease during PBT. GGT and T-Bil were elevated by 1.62 and 1.57 times in patients who received 66 Gy (RBE) in 10 fractions and 74 Gy (RBE) in 37 fractions, respectively, but again these changes were temporary. These results suggest that direct damage to normal liver caused by PBT is minimal, even if a patient has abnormal pretreatment enzyme levels.

Comparison of clinicopathological traits and prognostic factors of hepatocellular carcinoma with and without cirrhotic background

2020 ◽  
Vol 41 (11) ◽  
pp. 1576-1582
Author(s):  
Jian Hu ◽  
Zhi-Qing Zhang ◽  
Wei Zhu ◽  
Zhen-Ru Wu ◽  
Yu You ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Animal Model ◽  
Risk Factor ◽  
Prognostic Factors ◽  
Independent Risk Factor ◽  
Weight Ratio ◽  
The Difference ◽  
Hepatic Portal ◽  
Stratified Analysis ◽  
Glutamyl Transpeptidase

Abstract The difference of the patients bearing hepatocellular carcinoma (HCC) with and without cirrhosis at clinical level has not been completely determined. This study compared their differences in clinicopathological traits and prognostic factors for relapse-free survival (RFS) and overall survival (OS). Animal model was established to validate the result of clinical observation. As a result, 82 patients bearing HCC with no cirrhosis (HCC-NC) and 146 patients bearing HCC with cirrhosis (HCC-C) were included. HCC-NC exhibited shorter prothrombin time and higher plasma albumin than HCC-C. In HCC-NC, satellite nodule was an independent risk factor for OS, and high γ-glutamyl transpeptidase was an independent risk factor for RFS. In HCC-C, female sex was an independent risk factor for OS. Stratified analysis showed the OS and RFS of HCC-NC were better than HCC-C in conditions like without cancer embolus (in the portal vein or bile duct), without lymphadenopathy in hepatic portal, without satellite nodule and with small or high-differentiated tumor. Animal model analysis showed HCC-NC had a higher liver/body weight ratio, less tumor count and smaller max tumor volume than HCC-C. In conclusion, clinicopathological traits and risk factors influencing postoperative OS and RFS differed between patients with HCC-C and HCC-NC.

Sign in / Sign up

Export Citation Format

Share Document