Elevated preoperative peripheral blood monocyte count predicts poor prognosis for hepatocellular carcinoma after curative resection

Abstract

BackgroundPeripheral blood monocyte count is an easily assessable parameter of systemic inflammatory response. The aim of this study was to determine whether monocyte count was prognostic in hepatocellular carcinoma (HCC) following hepatic resection.MethodsWe retrospectively reviewed 351 patients with HCC treated with hepatic resection from 2006 to 2009. Preoperative absolute peripheral monocyte count, demographics, and clinical and pathological data were analyzed.ResultsOn univariate and multivariate analysis, elevated monocyte counts (≥545/mm3), tumor size ≥5 cm, non-capsulation, and multiple tumors were associated with poor disease-free survival (DFS) and overall survival (OS). The 1-, 3- and 5-year DFS rates were 58%, 41% and 35%, respectively, for patients with monocyte counts <545/mm3, and 36%, 23% and 21% for patients with monocyte counts ≥545/mm3. Correspondingly, the 1-, 3- and 5-year OS rates were 79%, 53% and 46% for monocyte counts <545/mm3, and 64%, 36% and 29% for monocyte counts ≥545/mm3. Subgroup analysis indicated that DFS after hepatic resection in hepatitis B virus (HBV)-infected patients was significantly better in those with a peripheral blood monocyte counts <545/mm3, but it did not differ between patients without HBV infection. In addition, DFS was significantly better for patients with a peripheral blood monocyte count <545/mm3, whether or not cirrhosis was present. Patients with elevated monocyte counts tended to have larger tumors.ConclusionsElevated preoperative monocyte count is an independent predictor of worse prognosis for patients with HCC after hepatic resection, especially for those with HBV infection. Postoperative adjuvant treatment might be considered for patients with elevated preoperative monocyte counts.

Prognostic significance of preoperative absolute peripheral monocyte count in esophageal squamous cell carcinoma

“…Owing to the producible, convenient, and inexpensive nature of circulating inflammation markers, great interests have been generated in elucidating their role in predicating cancer recurrence and death. Until now, the association between high peripheral blood monocytes and inferior survival has been proven in various malignancies, such as hepatocellular carcinoma, oral cavity cancer, oropharyngeal cancer, and lung cancer, as we have mentioned before . Our study evaluated the prognostic significance of peripheral blood monocytes in patients with ESCC who underwent esophagectomy.…”

“…13 Recently, the pretreatments peripheral blood monocyte count and monocyte ratio have also been shown to be a convenient and inexpensive prognostic factor in various solid tumors, including hepatocellular carcinoma, oral cavity cancer, oropharyngeal cancer, and lung cancer. [14][15][16][17] These results indicate that peripheral blood monocytes are associated with a pro-inflammatory immune response in a tumor-promoting direction and promote tumor angiogenesis.…”

“…Until now, the association between high peripheral blood monocytes and inferior survival has been proven in various malignancies, such as hepatocellular carcinoma, oral cavity cancer, oropharyngeal cancer, and lung cancer, as we have mentioned before. [14][15][16]23 Our study evaluated the prognostic significance of peripheral blood monocytes in patients with ESCC who underwent esophagectomy.…”

“…In the presence of granulocyte–macrophage colony‐stimulating factor and interleukin‐4, monocytes differentiate into immature dendritic cells, which are less effective at capturing antigens and defective in T‐cell stimulatory capacity . Recently, the pretreatments peripheral blood monocyte count and monocyte ratio have also been shown to be a convenient and inexpensive prognostic factor in various solid tumors, including hepatocellular carcinoma, oral cavity cancer, oropharyngeal cancer, and lung cancer . These results indicate that peripheral blood monocytes are associated with a pro‐inflammatory immune response in a tumor‐promoting direction and promote tumor angiogenesis.…”

Low frequency, weak MCP-1 secretion and exhausted immune status of peripheral monocytes were associated with progression of severe enterovirus A71-infected hand, foot and mouth disease

“…Previous studies have shown that monocytes primarily mediate a robust innate immune response to systemic infection, and the recruitment of monocytes is a feature of the inflammatory response to infection [11,12]. Clinical studies also provided clues about the relationship between monocytes and viral pathogenesis, elevated preoperative monocyte count being an independent predictor of worse prognosis for patients with HCC after hepatic resection, especially for those with an HBV infection [27]. Clinical studies also provided clues about the relationship between monocytes and viral pathogenesis, elevated preoperative monocyte count being an independent predictor of worse prognosis for patients with HCC after hepatic resection, especially for those with an HBV infection [27].…”