Author information
1
Northern Centre for Cancer Care, Newcastle-upon-Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne NE2 7DN, UK.
2
Northern Institute for Cancer Research, The Medical School, Newcastle University, Paul O'Gorman Building, Framlington Place, Newcastle-upon-Tyne NE2 4HH, UK.
3
State Key Laboratory in Oncology of South China, Department of Clinical Oncology, Chinese University of Hong Kong, Hong Kong, Hong Kong.
4
Institute of Digestive Disease, Chinese University of Hong Kong, Hong Kong, Hong Kong.
5
State Key Laboratory in Oncology of South China, Department of Anatomical and Cellular Pathology, Chinese University of Hong Kong, Hong Kong, Hong Kong.
6
State Key Laboratory in Oncology of South China, Department of Chemical Pathology, Chinese University of Hong Kong, Hong Kong, Hong Kong.
7
Institute of Cellular Medicine, The Medical School, Newcastle University, Framlington Place, Newcastle-upon-Tyne, NE2 4HH, UK.
8
Hepatopancreatobiliary Unit, Surgical Directorate, Freeman Hospital, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne NE2 7DN, UK.
9
The Liver Unit, Freeman Hospital, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne NE2 7DN, UK.
Abstract
BACKGROUND:
Irrespective of the underlying aetiology, 90% of hepatocellular carcinomas arise and progress on a background of chronic inflammation. We have explored the independent prognostic value of circulating inflammatory cells.
METHODS:
Peripheral blood count data sets from 583 consecutive patients presenting to a single UK centre (2000-2010) were analysed for associations with tumour stage, liver function, performance status (PST) and survival. Validation was in an independent Hong Kong cohort (585 patients; 2007-2013).
RESULTS:
In both UK and Hong Kong cohorts, neutrophils, platelets, lymphocytes, the neutrophil/lymphocyte ratio (NLR) and the Systemic Immune-Inflammation Index (SII) correlated stepwise, either increasing or decreasing (lymphocytes), with tumour node metastasis (TNM) and Childs-Pugh stage, PST and consequently with the combined Barcelona Clinic for Liver Cancer stage. Survival analyses confirmed the NLR and SII as highly significant prognostic biomarkers. Focused on individual cell types, only the neutrophil count was independently associated with both TNM stage and PST, as well as being significantly and independently associated with poorer survival.
CONCLUSIONS:
In this study of 1168 patients, neutrophils alone, rather than lymphocytes or platelets, were independently associated with outcome. These data support further characterisation of a potentially distinctive role for neutrophils as facilitators of tumour progression and deteriorating performance.