Background

Systemic inflammation-related factors, either independently or in combination, are recognized as prognostic factors for various cancers. The ratio of lymphocyte count to C-reactive protein concentration (lymphocyte–CRP ratio; LCR) is a recently identified prognostic marker for several cancers. Here, we examined the prognostic value of the LCR in patients with hepatocellular carcinoma (HCC).

Methods

This was a single-center retrospective study of patients who underwent surgical resection for HCC between 2004 and 2017. Patients were divided into high- and low-LCR status groups, and the relationships between LCR status, prognosis, and other clinicopathological characteristics were analyzed.

Results

A total of 454 patients with HCC were enrolled and assigned to the high- (n=245) or low- (n=209) LCR groups. Compared with the high-LCR group, patients in the low-LCR group had a significantly lower serum albumin level (median 4.1 vs. 3.9 g/dL, P <0.0001), lower platelet count (median 14.0 vs. 12.0 ×10⁴/μL, P=0.0468), lower prothrombin time (median 93.2 vs. 89.6 %, P=0.0006), and larger tumor size (median 2.3 vs. 2.5 cm, P=0.0056). Patients with low-LCR status had significantly worse outcomes of overall survival and disease-free survival than patients with high-LCR status (P=0.0003 and P=0.0069, respectively). Low-LCR status was significantly associated with worse overall survival in multivariate analysis (hazard ratio 1.57, 95% confidence interval 1.14–2.17, P=0.0058).

Conclusions

Low-LCR status may predict worse outcomes in patients with HCC. Measurement of LCR is routine and can easily be applied for risk stratification in the assessment of patients with HCC.

中文翻译：

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淋巴细胞-C反应蛋白比率对接受肝细胞癌手术切除的患者预后的影响

 背景

全身炎症相关因素，无论是独立的还是组合的，都被认为是各种癌症的预后因素。淋巴细胞计数与 C 反应蛋白浓度的比率（淋巴细胞-CRP 比率；LCR）是最近确定的几种癌症的预后标志物。在这里，我们检查了 LCR 对肝细胞癌 (HCC) 患者的预后价值。

 方法

这是一项单中心回顾性研究，对象为2004年至2017年间接受手术切除的HCC患者。将患者分为高LCR状态组和低LCR状态组，分析LCR状态、预后和其他临床病理特征之间的关系。

 结果

共有 454 名 HCC 患者入组，并被分配到高 LCR 组 (n=245) 或低 LCR 组 (n=209)。与高LCR组相比，低LCR组患者的血清白蛋白水平显着降低（中位数4.1 vs. 3.9 g/dL， P <0 id=95>4 /μL， P =0.0468），凝血酶原水平较低时间（中位数 93.2 % vs. 89.6 %， P = 0.0006），以及较大的肿瘤尺寸（中位数 2.3 vs. 2.5 cm， P = 0.0056）。低 LCR 状态患者的总生存率和无病生存率显着低于高 LCR 状态患者（分别为P = 0.0003 和P = 0.0069）。多变量分析显示，低 LCR 状态与较差的总生存率显着相关（风险比 1.57，95% 置信区间 1.14–2.17， P = 0.0058）。

 结论

低 LCR 状态可能预测 HCC 患者的预后较差。 LCR 测量是常规检查，可以轻松应用于 HCC 患者评估中的风险分层。