中性粒细胞/淋巴细胞比值与早期原发性肝细胞癌临床病理特征及预后的相关性

Correlation of neutrophil-to-lymphocyte ratio with the clinicopathological characteristics and prognosis of early primary hepatocellular carcinoma

目的：探讨中性粒细胞／淋巴细胞比值（neutrophil—to—lymphocyte ratio，NLR）与早期原发性肝细胞癌（hepatocellula rcarcinoma，HCC）临床病理特征及预后的相关性。方法：收集113例早期HCC患者与110例乙型肝炎肝硬化患者的临床资料。比较2组患者间甲胎蛋白（alpha—fetoprotein，AFP）表达量、乙型肝炎病毒（hepatitis Bvirus，HBV）-DNA、HCC病理分级和NLR等病理指标的差异。分析不同NLR（NLR〈3．65与NLR≥3．65）之间HCC患者无瘤生存率和总生成率的差异，并通过logistic回归分析影响HCC发生的因素，COX回归分析影响HCC术后复发的因素。结果：NLR在HCC组及乙型肝炎肝硬化组间差异有统计学意义（t=3．546，P〈0．05）；Spearman相关分析结果显示，NLR高低与病理分化程度呈负相关（r=-0．408，P〈0．001）。log—rank检验分析结果显示，不同的NLR（NLR〈3．65与NLR≥3．65）组间HCC术后无瘤生存率差异有统计学意义嘭=40．838，P〈0．001），而总生存率差异无统计学意义（χ^2=0．046，P〉0．05）；多因素logistic回归分析显示，NLR、谷丙转氨酶（alaninetransaminase，ALT）及γ-谷氨酰转肽酶（γ-glutamyl transferase，γ-GGT）对HCC发生有影响；CCX回归分析结果显示，NLR和HCC复发有关（比值比为2．271，P〈0．01）。结论：NLR高低与HCC的发生具有相关性，NLR越高HCC的分化程度越低，且术后3年内复发率越高，但与术后3年总生成率无关。

Objective： To explore the correlation of neutrophil-to-lymphocyte ratio （NLR） with the clinicopathological characteristics and prognosis of early primary hepatocellular carcinoma （HCC）.Methods： The clinical data of 113 patients with early HCC and 110 patients with hepatitis B cirrhosis were collected. The expression of alpha-fetoprotein （AFP）, copy number of hepatitis B virus （HBV）-DNA, pathological grade of HCC tissues, NLR and other pathological indicators between the two groups were compared. The differences in disease-free survival rate and overall survival rate were analyzed between the different levels of NLR （NLR 〈 3.65 vs NLR ≥ 3.65）. The factors influencing the occurrence of HCC were analyzed by logistic regression, while the factors influencing the postoperative recurrence of HCC were analyzed by COX regression. Results： A significant difference in NLR was found between HCC and hepatitis B cirrhosis groups （t = 3.546, P 〈 0.05）. Spearman correlation analysis showed that NLR was negatively correlated with the pathological differentiation degree of HCC （r = -0.408, P 〈 0.001）. Logrank analysis showed that the postoperative disease-free survival rate of HCC patients was significantly different according to the different NLR （χ^2 = 40.838, P 〈 0.001）, but the overall survival rate was not significantly different （χ^2 = 0.046, P 〉 0.05）. Multivariate logistic regression analysis showed that the occurrence of HCC had been influenced by NLR, alanine transaminase （ALl-） and y-glutamyl transferase （y-GGT）. COX regression analysis showed that NLR was correlated with the recurrence of HCC （odds ratio = 2.271, P 〈 0.01）. Conclusion：NLR is correlated with the occurrence of HCC. The higher the NLR, the lower the differentiation clegree of HCC, and the higher the recurrence rate of HCC patients in 3 years after surgery. But the overall survival rate of HCC patients in 3 years after operation is not associated with NLR.