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Abstract Details
The prognostic and diagnostic significance of the neutrophil-to-lymphocyte ratio in hepatocellular carcinoma: a prospective controlled study
Br J Cancer. 2021 Jun 14. doi: 10.1038/s41416-021-01445-3. Online ahead of print.
Philip J Johnson1, Sofi Dhanaraj2, Sarah Berhane3, Laura Bonnett4, Yuk Ting Ma5
Author information
1Department of Molecular and Clinical Cancer Medicine, University of Liverpool, Liverpool, UK. Philip.Johnson@liverpool.ac.uk.
2Liver Services, University Hospitals NHS Foundation Trust, Birmingham, UK.
3Institute of Applied Health Research, University of Birmingham, Birmingham, UK.
4Department of Health Data Science, University of Liverpool, Liverpool, UK.
5Institute of Immunology and Immunotherapy, University of Birmingham, Birmingham, UK.
Abstract
Background: The neutrophil-lymphocyte ratio (NLR), a presumed measure of the balance between neutrophil-associated pro-tumour inflammation and lymphocyte-dependent antitumour immune function, has been suggested as a prognostic factor for several cancers, including hepatocellular carcinoma (HCC).
Methods: In this study, a prospectively accrued cohort of 781 patients (493 HCC and 288 chronic liver disease (CLD) without HCC) were followed-up for more than 6 years. NLR levels between HCC and CLD patients were compared, and the effect of baseline NLR on overall survival amongst HCC patients was assessed via multivariable Cox regression analysis.
Results: On entry into the study ('baseline'), there was no clinically significant difference in the NLR values between CLD and HCC patients. Amongst HCC patients, NLR levels closest to last visit/death were significantly higher compared to baseline. Multivariable Cox regression analysis showed that NLR was an independent prognostic factor, even after adjustment for the HCC stage.
Conclusion: NLR is a significant independent factor influencing survival in HCC patients, hence offering an additional dimension in prognostic models.