摘要
目的评价肝癌肝移植患者术前外周血中性粒细胞／淋巴细胞比值（NLR）对术后肝癌复发的影响。方法回顾性分析中山大学第三附属医院76例乙型肝炎相关性肝细胞癌患者临床资料，单因素分析术前最大肿瘤直径、肿瘤数目、血管侵犯、甲胎蛋白（AFP）水平、中性粒细胞／淋巴细胞比值（NLR）、术后最大肿瘤直径、术后肿瘤数目和病理组织学分级等对术后无瘤生存率的影响，有统计学意义的术前单因素进入Cox回归模型多因素分析。结果1、3、5年的无瘤生存率分别为69．2％、52．7％和50．9％。NLR〈2．5和NLR≥2．5（37例）的患者1、3、5年的无瘤生存率分别为81．1％、66．9％、63．3％和56．3％、37．6％、37．6％（P=0．011）。单因素分析显示术前最大肿瘤直径〉5cm、肿瘤数目〉3、有大血管侵犯、AFP／〉400μg／L和NLRI〉2．5影响术后无瘤生存率。Cox回归分析显示肿瘤数目〉3、血管侵犯和NLR≥2．5为影响肝癌肝移植术后肿瘤复发的独立危险因素。结论术前高NLR的肝癌肝移植患者术后肿瘤复发的风险增加。
Objective To analyze the negative impact of preoperative neutrophil-lymphocyte ratio （NLR） on the tumor recurrence of hepatocellular carcinoma （HCC） after orthotopic liver transplantation. Methods The clinical data of HBV （ hepatitis B virus） -associated HCC patients undergoing liver transplantation were retrospectively analyzed. Their clinical and pathological risk factors for tumor-free survival were evaluated by univariate analysis. The analysis of Cox multiple regression was performed to determine the parameters of predicting the HCC recurrence. NLR≥2. 5 was considered to be elevated. Results A total of 76 patients were identified. Among them, 37 had an elevated NLR. The 1, 3 and 5-year tumor-free survival rates were 69. 2%, 52. 7% and 50. 9% respectively. The disease-free survival for patients with high NLR was significantly worse than that for those with normal NLR （ 1, 3, and 5 year survivals at 56. 3%, 37. 6% and 37.6% vs 81.1% , 66. 9% and 63.3% respectively; P =0. 011 ）. Univariate analysis of factors revealed that tumor size 〉 5 cm, tumor number 〉 3, vascular invasion, serumctfetoprotein level I〉 400 μg/L and NLR≥2. 5 were preoperative predictors of disease-free survival. Cox regression analysis showed that the presence of vascular invasion, tumor number 〉 3 and NLR I〉 2. 5 were independent prognostic factors of worse disease-free survival. Conclusion An elevated NLR significantly increases the risk for tumor recurrence in HCC patients undergoing liver transplantation.
出处
《中华医学杂志》
CAS
CSCD
北大核心
2011年第22期1519-1522,共4页
National Medical Journal of China
基金
国家高技术研究“973”发展计划项目（2009CB522404）
国家自然科学基金（30972914
81000190）
关键词
肝移植
肝细胞癌
预后
复发
无瘤生存率
Liver transplantation
Carcinoma, hepatocellular
Prognosis
Recurrence
Disease-free survival
