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The Prognostic Value of Inflammation Factors in Hepatocellular Carcinoma Patients with Hepatic Artery Interventional Treatments: A Retrospective Study

Authors Guo L, Ren H, Pu L, Zhu X, Liu Y, Ma X

Received 12 April 2020

Accepted for publication 26 June 2020

Published 13 August 2020 Volume 2020:12 Pages 7173—7188


Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 2

Editor who approved publication: Dr Chien-Feng Li

Linghong Guo,1,2,* Honghong Ren,2,* Lutong Pu,2 Xingyu Zhu,2 Yin Liu,1,3,4 Xuelei Ma1

1Department of Biotherapy, Cancer Center, West China Hospital, Sichuan University, Chengdu, Sichuan, People’s Republic of China; 2West China School of Medicine, Sichuan University, Chengdu, People’s Republic of China; 3Department of Pharmacology, West China School of Basic Sciences & Forensic Medicine, Sichuan University, Chengdu, Sichuan, People’s Republic of China; 4Department of Anesthesiology, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China, Chengdu, Sichuan, People’s Republic of China

*These authors contributed equally to this work

Correspondence: Xuelei Ma
Department of Biotherapy, Cancer Center West China Hospital, Sichuan University, No. 37, Guoxue Alley, Chengdu, Sichuan 610041, People’s Republic of China
Tel/ Fax +86-28-85475576

Background: Hepatic artery interventional therapy has been recognized as the first choice for advanced liver cancer. However, reliable prognostic markers are still lacking. In the present study, we aimed to evaluate the prognostic value of inflammation factors including neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR) and monocyte to lymphocyte ratio (MLR) in hepatocellular carcinoma (HCC) patients with hepatic artery interventional treatments.
Methods: Patients undergoing hepatic artery interventional therapy after being diagnosed with HCC between 2007 and 2014 were enrolled. Pre-treatment NLR, PLR and MLR were calculated, and all factors including gender, age, TNM stage, BCLC staging, inflammation factors, LDH, ALP, CEA, AFP, hepatitis, liver cirrhosis, portal vein involvement, surgical history and hepatic artery interventional treatment on overall survival (OS) were evaluated by the univariate and multivariate Cox proportional hazards analyses.
Results: Overall, 407 patients were included. The optimal cutoff values determined by receiver operating characteristic (ROC) curve analyses for NLR, PLR and MLR were 3.82, 140.00 and 0.27, respectively. High NLR was associated with worse OS (median survival time: high NLR group 9 vs low NLR group 19 months, HR 1.842, 95% CI: 1.457– 2.329, P< 0.001). Elevated PLR was negatively correlated with OS (8 vs 18 months, HR 1.677, 95% CI: 1.302– 2.161, P< 0.001). Patients in high MLR group had a worse OS (10 vs 21 months, HR 1.626, 95% CI: 1.291– 2.048, P< 0.001). In multivariate analysis, NLR, LDH, ALP and portal vein involvement were independent prognostic factors for OS of HCC patients after hepatic artery interventional therapy. In addition, for patients in BCLC stage A and B, higher NLR, PLR and MLR were all significantly negatively correlated to median survival time (NLR: 17 vs 26 months, HR: 1.739 (95% CI: 1.279– 2.365), P< 0.001; PLR: 18 vs 26 months, HR: 1.681 (95% CI: 1.245– 2.271), P=0.001; MLR: 20 vs 26 months, HR: 1.589 (95% CI: 1.185– 2.129), P=0.002).
Conclusion: Elevated pre-treatment NLR, PLR and MLR were associated with worse survival time in HCC patients after hepatic artery interventional therapy. Among them, NLR was an independent prognostic factor for OS.

Keywords: hepatocellular carcinoma, neutrophils, platelets, lymphocytes, inflammation, prognosis

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