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术前中性粒细胞/淋巴细胞比值对肝细胞肝癌患者移植术后复发的影响

The influence of preoperative neutrophil/lymphocyte ratio on recurrence of patients with hepatocellular carcinoma patients after liver transplantation

  • 摘要:
    目的 探讨外周血中性粒细胞/淋巴细胞比值(neutrophil/lymphocyte ratio, NLR)预测肝细胞肝癌(hepatocellular carcinoma, HCC)患者肝移植手术后不良预后的意义。
    方法 回顾性分析2017年1月至2020年12月在复旦大学附属中山医院首次进行肝移植手术的HCC患者的实验室检查数据及临床资料。以NLR=1.97为临界标准将患者分为2组,采用Kaplan-Meier生存曲线比较2组患者复发情况。采用单因素及多因素Cox回归分析HCC患者肝移植术后复发影响因素。
    结果 共纳入149例患者,其中男性125例、女性24例。Kaplan-Meier生存曲线显示,NLR≥1.97组(n=111)患者术后复发率高于NLR<1.97组(n=38,P=0.002)。单因素Cox回归分析显示,NLR与HCC患者肝移植术后复发有关(P=0.004);多因素Cox回归分析显示,NLR为HCC患者肝移植术后复发独立影响因素(P=0.033)。
    结论 NLR较高(≥1.97)的HCC患者肝移植手术后复发可能性更高,可用于评估患者预后。

     

    Abstract:
    Objective To investigate the significance of peripheral blood neutrophil/lymphocyte ratio (NLR) in predicting adverse prognosis of hepatocellular carcinoma (HCC) patients after liver transplantation.
    Methods The laboratory examination data and clinical data of HCC patients who underwent liver transplantation for the first time in Zhongshan Hospital, Fudan University from January 2017 to December 2020 were retrospectively analyzed. With 1.97 as the cut-off value of NLR, patients were divided into the 2 groups. Kaplan-Meier survival curve was used to the recurrence rate between the 2 groups.The univariate and multivariate Cox regression analyses were used to analyze the influence factors of HCC recurrence in patients after liver transplantation.
    Results A total of 149 patients met the inclusion criteria, including 125 males and 24 females. Kaplan-Meier survival curve showed that the postoperative recurrence rate in the NLR≥1.97 group (n=111) was significantly higher than that in the NLR < 1.97 group (n=38, P=0.002). Univariate Cox regression analysis showed that NLR was associated with recurrence of HCC patients after liver transplantation (P=0.004). Multivariate Cox regression analysis showed that NLR was an independent risk factor for the recurrence of HCC patients after liver transplantation.
    Conclusion The recurrence rate of HCC patients with higher NLR (≥1.97) after liver transplantation may be higher, and NLR could be used to evaluate the prognosis of these patients.

     

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