title: Neutrophil-to-lymphocyte ratio acts as a prognostic factor for patients with advanced hepatocellular carcinoma.
abstract: Few studies investigated the prognosis of patients with advanced hepatocellular carcinoma (aHCC). This study was aimed to determine the prognostic value of differential blood cell counts including blood white cells, neutrophil, lymphocyte, neutrophil-lymphocyte ratio (NLR), and platelet in patients with aHCC. A total of 205 ethnic Chinese aHCC patients receiving non-systematic sorafenib were analyzed retrospectively. The prognostic value of differential blood cell counts and NLR for overall survival (OS) was determined by integration into Cancer of the Liver Italian Program (CLIP) score system using backward elimination model of multivariate Cox regression. As a result, NLR was confirmed to be an independent predictor for OS (p = 0.001) with the rest parameters presented negative results. Then, aHCC patients were dichotomized into two groups according to NLR values ≤ 2.43 or >2.43. Patients with low NLR presented lower CLIP score and higher 6-month survival rate (56.1 vs 25.9%) compared with patients with high NLR level. Besides, low NLR level was associated with favorable prognostic factors such as lower α-fetoprotein, alkaline phosphatase, and total bilirubin, as well as decreased incidence of ascites, portal vein thrombosis, and metastasis. Besides, low NLR level was associated less white cells and neutrophil granulocytes, as well as more lymphocyte. In summary, the present study firstly indentified NLR as an independent prognostic factor in aHCC patients receiving no systematic sorafenib.
authors.affiliation: Department of Medical Oncology, The Third Affiliated Hospital of Sun Yat-sen University, 600 Tianhe Road, Guangzhou, 510630, People's Republic of China.
authors.forename: Xing
authors.initials: X
authors.lastname: Li
authors.forename: Zhan-Hong
authors.initials: ZH
authors.lastname: Chen
authors.forename: Xiao-Kun
authors.initials: XK
authors.lastname: Ma
authors.forename: Jie
authors.initials: J
authors.lastname: Chen
authors.forename: Dong-Hao
authors.initials: DH
authors.lastname: Wu
authors.forename: Qu
authors.initials: Q
authors.lastname: Lin
authors.forename: Min
authors.initials: M
authors.lastname: Dong
authors.forename: Li
authors.initials: L
authors.lastname: Wei
authors.forename: Tian-Tian
authors.initials: TT
authors.lastname: Wang
authors.forename: Dan-Yun
authors.initials: DY
authors.lastname: Ruan
authors.forename: Ze-Xiao
authors.initials: ZX
authors.lastname: Lin
authors.forename: Yan-Fang
authors.initials: YF
authors.lastname: Xing
authors.forename: Yun
authors.initials: Y
authors.lastname: Deng
authors.forename: Xiang-Yuan
authors.initials: XY
authors.lastname: Wu
authors.forename: Jin-Yun
authors.initials: JY
authors.lastname: Wen
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006528:Carcinoma, Hepatocellular / Q000401:mortality / Q000556:secondary*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008113:Liver Neoplasms / Q000401:mortality / Q000473:pathology*; D008207:Lymphatic Metastasis; D008214:Lymphocytes / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D009504:Neutrophils / Q000473:pathology*; D011379:Prognosis; D012189:Retrospective Studies; D015996:Survival Rate; D055815:Young Adult
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