title: Association of neutrophil-lymphocyte ratio and T lymphocytes with the pathogenesis and progression of HBV-associated primary liver cancer.
abstract: BACKGROUND
  The neutrophil-lymphocyte ratio (NLR) is a new prognostic predictor for patients with liver cancer. The association of NLR and T lymphocytes with the pathogenesis and progression of liver cancer is poorly understood.
  
  
  METHODS
  Seventy-three patients with hepatitis B virus (HBV)-associated primary liver cancer (HBV-PLC), 50 patients with HBV-associated liver cirrhosis (HBV-LC) and 37 patients with chronic HBV infection (CHB) were prospectively enrolled from July 1, 2013 to February 28, 2014 in Beijing Ditan Hospital, Capital Medical University (Beijing, China). The NLR, proportions and concentrations of neutrophils and lymphocytes, concentration of subpopulations of lymphocytes, and the expression of CD31 (index for recent thymic output) and HLA-DR (index for activation of T lymphocytes) of T cells in the peripheral blood samples of the patients were assessed and statistically compared between different groups.
  
  
  RESULTS
  The NLR was significantly increased from patients with CHB, those with HBV-LC to those with HBV-PLC (P<0.05), along with significant increase of neutrophils and decrease of lymphocytes in the same way (P<0.05). The concentrations of T lymphocytes, natural killer cells, B cells, CD4+ T cells and CD8+ T cells were decreased from patients with CHB, those with HBV-LC to those with HBV-PLC, and were significantly reduced in patients with HBV-PLC compared with those in patients with CHB (P<0.05). The CD31 and HLA-DR expression of naive CD4+ and CD8+ T cells was significantly decreased and increased, respectively in patients with HBV-PLC compared with that in patients with CHB.
  
  
  CONCLUSIONS
  Elevated NLR, resulted from the increase of neutrophils and decrease of lymphocytes, is positively associated with the pathogenesis and progression of HBV-PLC. The reduced thymic output and hyperactivation of T lymphocytes may contribute to the decrease of T lymphocytes, which could be also related to the pathogenesis of HBV-PLC.
authors.affiliation: Center for Integrative Medicine, Beijing Ditan Hospital, Capital Medical University, Beijing, P.R. China.
authors.forename: Xiaoli
authors.initials: X
authors.lastname: Liu
authors.affiliation: Center for Integrative Medicine, Beijing Ditan Hospital, Capital Medical University, Beijing, P.R. China.
authors.forename: Lingling
authors.initials: L
authors.lastname: He
authors.affiliation: Institute of Infectious Diseases, Beijing Key Laboratory of Emerging Infectious Diseases, Beijing Ditan Hospital, Capital Medical University, Beijing, P.R. China.
authors.forename: Junyan
authors.initials: J
authors.lastname: Han
authors.affiliation: Center for Integrative Medicine, Beijing Ditan Hospital, Capital Medical University, Beijing, P.R. China.
authors.forename: Lijia
authors.initials: L
authors.lastname: Wang
authors.affiliation: Center for Integrative Medicine, Beijing Ditan Hospital, Capital Medical University, Beijing, P.R. China.
authors.forename: Mengge
authors.initials: M
authors.lastname: Li
authors.affiliation: Center for Integrative Medicine, Beijing Ditan Hospital, Capital Medical University, Beijing, P.R. China.
authors.forename: Yuyong
authors.initials: Y
authors.lastname: Jiang
authors.affiliation: Center for Integrative Medicine, Beijing Ditan Hospital, Capital Medical University, Beijing, P.R. China.
authors.forename: Xianbo
authors.initials: X
authors.lastname: Wang
authors.affiliation: Center for Integrative Medicine, Beijing Ditan Hospital, Capital Medical University, Beijing, P.R. China.
authors.forename: Zhiyun
authors.initials: Z
authors.lastname: Yang
mesh_terms: D000328:Adult; D018450:Disease Progression; D005260:Female; D006515:Hepatitis B virus / Q000302:isolation & purification*; D019694:Hepatitis B, Chronic / Q000097:blood* / Q000150:complications* / Q000473:pathology / Q000821:virology; D006801:Humans; D007958:Leukocyte Count; D008103:Liver Cirrhosis / Q000097:blood / Q000473:pathology / Q000821:virology; D008113:Liver Neoplasms / Q000097:blood* / Q000473:pathology / Q000821:virology*; D018655:Lymphocyte Count; D008297:Male; D008875:Middle Aged; D009504:Neutrophils / Q000473:pathology* / Q000821:virology; D011379:Prognosis; D013601:T-Lymphocytes / Q000473:pathology* / Q000821:virology; D013950:Thymus Gland / Q000473:pathology / Q000821:virology; D055815:Young Adult