关键词: 肝细胞肝癌, 中性粒细胞×, 单核细胞/淋巴细胞比值, 血小板/淋巴细胞比值, 复发, 预后

Abstract:

Predictive significance of preoperative SIRI combined with PLR in postoperative patients with hepatocellular carcinoma        ZHANG Jin-fu，FAN Zheng-jun，LIANG Run-wei，et al. Department of Hepatobiliary and Pancreatic Surgery，the First Affiliated Hospital of Zhengzhou University，Zhengzhou 450052,China
Corresponding author : FAN Zheng-jun，E-mail：volcano0515@163.com
Abstract    Objective    To combine preoperative neutrophil×monocyte/lymphocyte ratio（SIRI）and platelet/lymphocyte ratio（PLR）, investigate the value of predicting tumor-free survival rate and overall survival rate in hepatocellular carcinoma（HCC） patients after curative hepatectomy. Methods    The clinical data of 126 HCC patients in the First Affiliated Hospital of Zhengzhou University from 2011 to 2012 underwent surgical treatment and postoperative pathological results all suggesting hepatocellular carcinoma were analyzed retrospectively. Patients′ medical data, preoperative laboratory tests, imageological data, surgery records were collected. The preoperative SIRI and PLR ratio of each patients were calculated, and follow-up was observed for each patients. Univariate and multivariate analysis were performed to identify the predictive value of above factors for tumor-free survival rate and overall survival rate. Results Indicators SIRI and PLR had a real accurate predictive value for HCC patients. The area under the curve of ROC of SIRI for diagnosis of tumor recurrence was 0.673, and that of PLR is 0.722. The preoperative SIRI and PLR level were significantly associated with the clinicopathologic factors that include BCLC stage, tumor size, vascular invasion, and so on（all P<0.05）. Cox hazards models analysis identified that preoperative SIRI and PLR level were independent prognostic factors for HCC recurrence and prognosis. Survival analysis showed that postoperative 1-, 3-, 5-year tumor-free survival rate and 1-,3-,5-year overall survival rate in patients with preoperative SIRI≤1.335 and PLR≤72.9 were significantly higher than those in patients with SIRI>1.335 and PLR>72.9. When the radio SIRI>1.335 and PLR>72.9, patients showed the worst prognosis, suggesting that patients might have a high risk of recurrence and poor prognosis. Conclusion    Preoperative SIRI and PLR are two reliable predictors, which can be used to predict the survival of HCC patients after surgical resection. The combination of SIRI and PLR increases the prognostic accuracy of testing.

Key words: hepatocellular carcinoma；neutrophil×monocyte/lymphocyte ratio ；platelet/lymphocyte , ratio ；recurrence ；prognosis