术前NLR水平对TACE联合MWA治疗的巨块型原发性肝癌患者生存时间的影响*

doi:10.3969/j.issn.1672-5069.2020.02.028

摘要/Abstract

摘要： 目的探讨术前中性粒细胞数与淋巴细胞数比率(NLR)对行经动脉化疗栓塞术(TACE)联合微波消融(MWA)治疗的巨块型肝细胞癌(HCC)患者生存时间的影响。方法 2007年1月～2013年10月我院收治行TACE联合MWA治疗的巨块型HCC患者87例,根据术前NLR水平分为≥2.37者47例和NLR＜2.37者40例,比较两组生存时间。结果高NLR组患者男性比例为78.7%,≥55岁比例为29.8%,肿瘤直径为(7.1±1.2) cm,Child-Pugh A级比例为61.7%,血清白蛋白水平≥35 g/L者比例为34.0%,血清ALT水平＞40 U/L者比例为76.7%,AST水平＞40 U/L者比例为53.2%,AFP水平≥200 μg/L 者比例为59.6%,与低NLR组的80.0%、27.5%、(6.9±1.1)cm、62.5%、30.0%、75.0%、57.5%和57.5%相比,差异无显著性(P >0.05);治疗后,低NLR组1 a、2 a和3 a生存率分别为92.5%(37/40)、62.5%(25/40)和20.0%(8/40),均显著高于高NLR组的55.3%(26/47)、31.9%(15/47)和8.5%(4/47,P <0.05);高NLR组和低NLR组患者中位生存时间分别为13(11～17)个月和28(23～33)个月(P <0.05)。结论术前NLR值可用于行TACE联合MWA治疗的巨块型HCC患者生存时间的预测,术前外周血中性粒细胞计数水平太高,一定存在一些影响预后的不良因素,应认真予以解决。

关键词: 肝细胞癌, 经动脉化疗栓塞术, 微波消融, 中性粒细胞数与淋巴细胞数比率, 预后

Abstract: Objective The aim of this study was to investigate the predicting value for survival by preoperative neutrophil-to-lymphocyte ratio (NLR) of patients with massive hepatocellular carcinoma (HCC) treated with TACE combined with microwave ablation (MWA). Methods 87 patients with massive HCC were recruited and treated with TACE combined with MWA in our hospital between January 2007 and October 2013, and they were divided into high (NLR≥2.37, n=47) and low NLR group (NLR<2.37, n=40 patients) pre-operationally. Results The males proportion was 78.7%, ≥55 years old was 29.8%, tumor diameter were (7.1±1.2) cm, Child-Pugh grade A proportion was 61.7%, the proportion of serum albumin ≥35 g/L was 34.0%, the proportion of serum ALT>40U/L was 76.7%, AST>40U/L was 53.2% and AFP ≥200 μg/L was 59.6% in patients with high NLR, not significantly different as compared to 80.0%, 27.5%,(6.9±1.1)cm, 62.5%, 30.0%, 75.0%, 57.5% and 57.5% in patients with low NLR(P>0.05); the survival rates at 1a , 2 a and 3 a in patients with low NLR after treatment were 92.5%(37/40),62.5%(25/40) and 20.0%(8/40), significantly higher than 55.3%(26/47),31.9%(15/47) and 8.5%(4/47) in patients with high NLR(P <0.05); the median survival time of patients with high and low NLR were 13(11-17)months and 28(23-33)months (P<0.05). Conclusion The NLR might predict the short-term and long-term survival in patients with massive hepatocellular carcinoma treated with TACE combined with MWA, and the higher blood neutrophil counts might impact the clinical prognosis.

Key words: Hepatoma, TACE, Microwave ablation, Neutrophil-to-lymphocyte ratio, Prognosis

王玮, 杜晓菲, 路运健. 术前NLR水平对TACE联合MWA治疗的巨块型原发性肝癌患者生存时间的影响^*[J]. 实用肝脏病杂志, 2020, 23(2): 260-263.

Wang Wei, Du Xiaofei, Lu Yunjian. Predicting value for survival by preoperative NLR of patients with massive hepatocellular carcinoma treated by TACE combined with MWA[J]. Journal of Practical Hepatology, 2020, 23(2): 260-263.

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术前NLR水平对TACE联合MWA治疗的巨块型原发性肝癌患者生存时间的影响^*

Predicting value for survival by preoperative NLR of patients with massive hepatocellular carcinoma treated by TACE combined with MWA

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