摘要
Background and Aims:Platelet-to-lymphocyte ratio(PLR)has been shown to predict prognosis of cancers.We aimed to evaluate the prognostic value of stratification of PLR in patients after curative liver resection(CLR)for hepatocellular carcinoma(HCC).Methods:A total of 1804 patients who underwent CLR for suspected HCC between January 2007 and January 2014 were screened for the study.All of the patients were categorized into equal tertiles according to the number of patients and the distribution of PLR.Prognostic significance was determined for overall survival(OS)and was assessed using Kaplan-Meier analysis.Univariate and multi-variate Cox proportional hazard regression analyses were evaluated for association of all independent parameters with disease prognosis.Results:The optimal cut-off points of preoperative PLR were:(T1)11.98-75.00,(T2)75.00-113.33 and(T3)113.33-567.50.There were obvious differences in each PLR tertile with mortality within 36 months of CLR(Plog-rank<0.001).Multivariable analysis suggested that the level of PLR(HR=1.004,95%CI:1.001-1.008,P=0.006),portal vein thrombosis(HR=3.406,95%CI:1.185-9.794,P=0.023),number of nodules(HR=1.810,95%CI:1.345-2.437,P<0.001),Child-Turcotte-Pugh score(HR=1.741,95%CI:1.129-2.684,P=0.012)and microvascular invasion(HR=2.730,95%CI:1.777-4.196,P<0.001)were significant predictors of mortality.Kaplan-Meier analysis of overall survival(OS)demonstrated that each PLR tertile showed a progressively worse OS and apparent separation(Plog-rank=0.016).The highest 5-year OS rate following CLR(58%)was revealed in tertile 1.In contrast,the lowest 5-year OS rate(30%)was revealed in tertile 3.Conclusion:Stratified preoperative PLR could strengthen the predictive power for OS in HCC patients with CLR.
基金
grants from the National Natural Science Foundation of China(81500665)
Scientific Research Foundation of Wenzhou(Y20160223)
High Level Creative Talents from Department of Public Health in Zhejiang Province,and the Project of New Century 551 Talent Nurturing in Wenzhou to MH Zheng
作者简介
Corresponding author:Ming-Hua Zheng,Department of Hepatology.Live-Research Center,The First Affiliated Hospital of Wenzhou Medical University;Insti­tute of Hepatology,Wenzhou Medical University,No.2 Fuxue Lane,Wenzhou 325000,China.Tel:+86577-88078232,Fax:+86-577-88078262,E-mail:zhengmh@wmu.edu.cn;Gui-Qian Huang,contributed equally to this study;Ji-Na Zheng,contributed equally to this study
