外周血相关参数对肝癌预后评估价值的研究进展
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摘要
肝癌的发病率位居我国恶性肿瘤的第3位,居肿瘤死亡原因的第4位。研究显示炎症促进肝细胞肝癌的恶性生物学行为,并且和患者的预后相关。有研究发现了一些与患者预后相关的参数,如中性粒细胞(N)、淋巴细胞(L)、血小板(PLT)、C反应蛋白(CRP)、红细胞分布宽度(RDW)、中性粒细胞/淋巴细胞(NLR)、血小板/淋巴细胞(PLR)、C反应蛋白/白蛋白(CRP/Alb)。研究显示N的浸润与肝癌患者预后较差相关。CD4+CD25+Fox P3+调节T细胞数量增加可能导致肝癌患者生存时间减少。PLT与肝癌的发展、生长、侵袭和转移是相关的。CRP的升高与肝癌患者预后不良相关。RDW升高的患者生存率明显较差。NLR升高与肝癌术后的复发和预后有明显的相关性。升高的PLR与肝癌患者的生存率相关。CRP/Alb可能是肝癌患者独立的预后指标。上述指标目前缺乏统一的标准,具体机制尚不清楚。文章对外周血相关参数对肝癌预后评估价值的研究进展作一综述。
The morbidity of hepatocellular carcinoma(HCC) is in the third, the leading causes of death is in the fourth in China. Recently,it is indicated that inflammation can facilitate maligant biological behaviors of hepatocellular carcinoma and associated with the prognosis of patients with HCC. It has been found that associated with the prognosis of patients for clinical commom parameters. Such as,neutrophil, lymphocyte, platelet, C-reactive protein(CRP),red b lood cell distribution width(RDW), neutrophil/lymphocyte ration(NLR), platelet/lymphocyte ration(PLR), CRP/albumin ration. Neutrophilic infiltration is associated with worse prognosis of HCC patients. It is found that increased numbers of CD4+CD25+FoxP3+ Treg may bring about poor survival of HCC patients. Platelet is associated with development,growth, invasion and metastasis of HCC. Elevated level of serum CRP is associated with poor prognosis of patients with HCC. The patients with preoperative high RDW was poor survival. High NLR has been found that siginificantly associated with recurrence and prognosis of patients with HCC after curative resection. Elevated PLR is associated with overall survival overall survival, disease-free survivaland recurrence-free survival of patients with HCC. CRP/albumin ration is an independent prognostic indicator of patients with HCC.Mentioned indicators above are lack of uniform standard. Specific mechanism is unclear. Here we review the research progress in the prognostic function of the peripheral blood relevant parameters in HCC.
The morbidity of hepatocellular carcinoma(HCC) is in the third, the leading causes of death is in the fourth in China. Recently,it is indicated that inflammation can facilitate maligant biological behaviors of hepatocellular carcinoma and associated with the prognosis of patients with HCC. It has been found that associated with the prognosis of patients for clinical commom parameters. Such as,neutrophil, lymphocyte, platelet, C-reactive protein(CRP),red b lood cell distribution width(RDW), neutrophil/lymphocyte ration(NLR), platelet/lymphocyte ration(PLR), CRP/albumin ration. Neutrophilic infiltration is associated with worse prognosis of HCC patients. It is found that increased numbers of CD4+CD25+FoxP3+ Treg may bring about poor survival of HCC patients. Platelet is associated with development,growth, invasion and metastasis of HCC. Elevated level of serum CRP is associated with poor prognosis of patients with HCC. The patients with preoperative high RDW was poor survival. High NLR has been found that siginificantly associated with recurrence and prognosis of patients with HCC after curative resection. Elevated PLR is associated with overall survival overall survival, disease-free survivaland recurrence-free survival of patients with HCC. CRP/albumin ration is an independent prognostic indicator of patients with HCC.Mentioned indicators above are lack of uniform standard. Specific mechanism is unclear. Here we review the research progress in the prognostic function of the peripheral blood relevant parameters in HCC.
引文
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[13]Mc Milan DC,Canna K,Mc Ardle CS.Systemic inflammatory Response predicts survival following curative resection of colorectal cancer[J].Br J Surg 2003,90(2):215-219.
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[15]Ay S,Eryilmaz MA,Aksoy N,et al.Is early detection of colon cancer possible with red blood cell distribution width?[J].Asian Pac J Cancer Prev,2015,16(2):753-756.
[16]Bucciarelli P,Maino A,Felicetta I,et al.Association between red cell distribution width and risk of venous thromboembolism[J].Thromb Res,2015,136(3):590-594.
[17]Halazun KJ,Hardy MA,Rana AA,et al.Negative impact of neutrophil-lymphocyte ratio on outcome after liver transplantation for hepatocellular carcinoma[J].Ann Surg,2009,250(1):141-151.
[18]Q Wang,S Blank,MI Fiel,et al.The Severity of Liver Fibrosis Influnces the Prognostic Value of Inflammation-Based Scores in Hepatitis B-Associated Hepatocellular Carcinoma[J].Ann Surg Oncol,2015,22(3):1-8.
[19]Mano Y,Shirabe K,Yamashita YI,et al.Preoperative neutrophilto-lymphocyte ratio is a predictor of survival after hepatectomy for hepatocellular carcinoma:a retrospective analysis[J].Ann Surg,2013,258(2):301-305.
[20]Liu Y,Wang ZX,Cao Y,et al.Preoperative inflammation-based markers pre-dict early and late recurrence of hepatocellular carcinoma after curative hepatectomy[J].Hepatobiliary Pan Int,2016,15(3):266-274.
[21]W Ma,P Zhang,J Qi,et al.Prognostic value of platelet to lymphocyte ratio in hepatocellular carcinoma:a meta-analysis[J].Scientific Reports,2016(6):35378.
[22]C Groden.Tumor-platelet interaction in solid tumors[J].Int J Cancer,2012,130(12):2747-2760.
[23]RL Stone,AM Nick,IA Mcneish,et al.Paraneoplastic thrombocytosis in ovarian cancer[J].N Engl J Med,2012,366(7):610-618.
[24]A Kinoshita,H Onoda,N Imai,et al.The C-reactive protein/albumin ratio,a novel inflammation-based prognostic score,predicts outcomes in patients with hepatocellular carcinoma[J].Ann Surg Oncol,2015,22(3):803-810.
[25]CSD Roxburgh,DC Mcmillan.Cancer and systemic inflammation:treat the tumour and treat the host[J].Br J Cancer,2014,110(6):1409-1412.
[2]Poon RT,Fan ST,CM Lo,et al.Long-term survival and pattern of recuence after resection of small hepatocellular carcinoma in patients with preserved liver function:implications for a strategy of salvage transplantation[J].Ann Surg,2002,235(3):373-382.
[3]Sun B,Karin M.Obesity,inflammation,and liver cancer[J].J Hepatol,2012,56(3):704-713.
[4]Imai Y,Kubota Y,Yamamoto S,et al.Neutrophils enhance invasion activity of human cholangiocellular carcinoma Cells:an in vitro study[J].J Gastroenterol Hepatol,2005,20(2):287-293.
[5]N Güng?r,AM Knaapen,A Munnia,et al.Genotoxic effects of neutrophils and hypochlorous acid[J].Mutagenesis,2010,25(2):149-154.
[6]De Larco JE,Wuertz BR,Furcht LT.The potential Role of neutrophils in promoting the metastasis phenotype of Tumors releasing interleukin-8[J].Clin Cancer Res,2004,10(15):4895-4900.
[7]Kusaba N,Kumashiro R,Ogata H,et al.In vitro study of neUtrophil apoptosis in liver cirrhosis[J].Intern Med,1983,37(1):11-17.
[8]J Fu,D Xu,Z Liu,et al.Increased regulatory T cells correlate with CD8 T-cell impairment and poor survival in hepatocellular carcinoma patients[J].Gastroenterology,2007,132(7):2328-2339.
[9]Baecher-Allan C,Anderson DE.regulatory cells and human cancer[J].Semin Cancer Biol,2006,16(2):98-105.
[10]Leslie M.Cell biology:beyond clotting:the powers of patelets[J].Science,2010,328(5978):562-564.
[11]Takagi S,Sato S,Oh-hara T,et al.Platelets Promote Tumor Growth and Metastasis via Direct Interaction between Aggrus/Podoplanin and CLEC-2[J].PLo S ONE,2013,8(8):e73609.
[12]Kinoshita A,Onoda H,Takano K,et al.pretreatment serum C-reactive protein level predicts poor prognosis in patients with hepatocellular carcinoma[J].Med Oncol,2012,29(4):2800-2808.
[13]Mc Milan DC,Canna K,Mc Ardle CS.Systemic inflammatory Response predicts survival following curative resection of colorectal cancer[J].Br J Surg 2003,90(2):215-219.
[14]T Zhao,L Cui,A Li.The significance of RDW in patients with hepatocellular carcinoma after radical resection[J].Cancer Biomarkers,2016,16(4):507-512.
[15]Ay S,Eryilmaz MA,Aksoy N,et al.Is early detection of colon cancer possible with red blood cell distribution width?[J].Asian Pac J Cancer Prev,2015,16(2):753-756.
[16]Bucciarelli P,Maino A,Felicetta I,et al.Association between red cell distribution width and risk of venous thromboembolism[J].Thromb Res,2015,136(3):590-594.
[17]Halazun KJ,Hardy MA,Rana AA,et al.Negative impact of neutrophil-lymphocyte ratio on outcome after liver transplantation for hepatocellular carcinoma[J].Ann Surg,2009,250(1):141-151.
[18]Q Wang,S Blank,MI Fiel,et al.The Severity of Liver Fibrosis Influnces the Prognostic Value of Inflammation-Based Scores in Hepatitis B-Associated Hepatocellular Carcinoma[J].Ann Surg Oncol,2015,22(3):1-8.
[19]Mano Y,Shirabe K,Yamashita YI,et al.Preoperative neutrophilto-lymphocyte ratio is a predictor of survival after hepatectomy for hepatocellular carcinoma:a retrospective analysis[J].Ann Surg,2013,258(2):301-305.
[20]Liu Y,Wang ZX,Cao Y,et al.Preoperative inflammation-based markers pre-dict early and late recurrence of hepatocellular carcinoma after curative hepatectomy[J].Hepatobiliary Pan Int,2016,15(3):266-274.
[21]W Ma,P Zhang,J Qi,et al.Prognostic value of platelet to lymphocyte ratio in hepatocellular carcinoma:a meta-analysis[J].Scientific Reports,2016(6):35378.
[22]C Groden.Tumor-platelet interaction in solid tumors[J].Int J Cancer,2012,130(12):2747-2760.
[23]RL Stone,AM Nick,IA Mcneish,et al.Paraneoplastic thrombocytosis in ovarian cancer[J].N Engl J Med,2012,366(7):610-618.
[24]A Kinoshita,H Onoda,N Imai,et al.The C-reactive protein/albumin ratio,a novel inflammation-based prognostic score,predicts outcomes in patients with hepatocellular carcinoma[J].Ann Surg Oncol,2015,22(3):803-810.
[25]CSD Roxburgh,DC Mcmillan.Cancer and systemic inflammation:treat the tumour and treat the host[J].Br J Cancer,2014,110(6):1409-1412.