Open Access

Derived neutrophil to lymphocyte ratio predicts prognosis for patients with HBV-associated hepatocellular carcinoma following transarterial chemoembolization

  • Authors:
    • Dongsheng Zhou
    • Jianzhong Liang
    • Li Xu
    • Fengying He
    • Zhongguo Zhou
    • Yaojun Zhang
    • Minshan Chen
  • View Affiliations

  • Published online on: March 21, 2016     https://doi.org/10.3892/ol.2016.4359
  • Pages: 2987-2994
  • Copyright: © Zhou et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

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Abstract

The derived neutrophil to lymphocyte ratio (dNLR) has been proposed as an easily determinable prognostic factor for cancer patients, but the prognostic significance of the dNLR in hepatocellular carcinoma (HCC) has not been investigated. The present study aimed to validate the prognostic power of the NLR and dNLR in HCC patients undergoing transarterial chemoembolization (TACE). The data of 279 consecutive patients who underwent TACE for unresectable HBV‑associated HCC between September 2009 and November 2011 at the Department of Hepatobiliary Surgery, Sun Yat‑sen University Cancer Center (Guangzhou, China) were retrieved from a prospective database. The cut‑off values for the NLR and dNLR were determined by receiver operating characteristic (ROC) analysis. The association between the NLR and dNLR and the clinicopathological characteristics and overall survival (OS) rates and times of patients was analyzed. The area under the curve (AUC) was calculated to evaluate the discriminatory ability of the NLR and dNLR. The median follow‑up period was 446 days, the 1, 2 and 3‑year OS rates were 38.8, 18.5 and 11.1% respectively, and the median OS time was 264 days. The cut‑off values were determined as 2.6 and 1.8 for the NLR and dNLR, respectively. The NLR and dNLR were each associated with patient age, presence of vascular invasion, tumor size, AST level and ALP level. Multivariate analysis showed that the NLR, dNLR, ALT level and AFP level were independent prognostic factors for OS. An elevated NLR or dNLR was associated with a poor prognosis (P=0.001 and P=0.002, respectively). The prognostic power of NLR [AUC=0.539; 95% confidence interval (CI), 0.423‑0.656] and dNLR (AUC=0.522; 95% CI, 0.406‑0.638) was similar. Elevated dNLR predicted poor prognosis for patients with HBV‑associated HCC undergoing TACE, with similar prognostic power to NLR. The dNLR may be used as an alternative to the NLR, as it is easily available and inexpensive.
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May-2016
Volume 11 Issue 5

Print ISSN: 1792-1074
Online ISSN:1792-1082

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Spandidos Publications style
Zhou D, Liang J, Xu L, He F, Zhou Z, Zhang Y and Chen M: Derived neutrophil to lymphocyte ratio predicts prognosis for patients with HBV-associated hepatocellular carcinoma following transarterial chemoembolization. Oncol Lett 11: 2987-2994, 2016
APA
Zhou, D., Liang, J., Xu, L., He, F., Zhou, Z., Zhang, Y., & Chen, M. (2016). Derived neutrophil to lymphocyte ratio predicts prognosis for patients with HBV-associated hepatocellular carcinoma following transarterial chemoembolization. Oncology Letters, 11, 2987-2994. https://doi.org/10.3892/ol.2016.4359
MLA
Zhou, D., Liang, J., Xu, L., He, F., Zhou, Z., Zhang, Y., Chen, M."Derived neutrophil to lymphocyte ratio predicts prognosis for patients with HBV-associated hepatocellular carcinoma following transarterial chemoembolization". Oncology Letters 11.5 (2016): 2987-2994.
Chicago
Zhou, D., Liang, J., Xu, L., He, F., Zhou, Z., Zhang, Y., Chen, M."Derived neutrophil to lymphocyte ratio predicts prognosis for patients with HBV-associated hepatocellular carcinoma following transarterial chemoembolization". Oncology Letters 11, no. 5 (2016): 2987-2994. https://doi.org/10.3892/ol.2016.4359