Lymphocyte-to-C-reactive protein ratio as a prognostic factor for hepatocellular carcinoma

Iseda, Norifumi; Itoh, Shinji; Yoshizumi, Tomoharu; Tomiyama, Takeshi; Morinaga, Akinari; Shimagaki, Tomonari; Wang, Huanlin; Kurihara, Toshio; Toshima, Takeo; Nagao, Yuhei; Harada, Noboru; Oda, Yoshinao; Mori, Masaki

doi:10.1007/s10147-021-01985-x

Cited by 37 publications

(34 citation statements)

References 36 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…29 , 30 For this reason, low PreLCR has been associated with poor immunological response, malnutrition, and/or enhancement of systemic inflammatory response in cancer patients, and it is a convenient prognostic marker for patients with HCC. 14 , 15 , 31 …”

Section: Discussionmentioning

confidence: 99%

Combining Pre- and Postoperative Lymphocyte–C-Reactive Protein Ratios Can Better Predict Hepatocellular Carcinoma Prognosis After Partial Hepatectomy

Ni¹,

Zhan²,

Huang³

et al. 2022

JIR

View full text Add to dashboard Cite

Background Various preoperative inflammatory indicators have been identified as potential predictors of poor prognosis in patients with hepatocellular carcinoma (HCC), but the role of postoperative inflammatory indicators remains unclear. This study aimed to explore the prognostic value of the postoperative lymphocyte–C-reactive protein ratio (PostLCR) on its own and combined with preoperative LCR (PreLCR). Methods A total of 290 patients with primary HCC were retrospectively enrolled in the study. Univariate analysis was used to identify factors significantly associated with poor disease-free survival (DFS) and overall survival (OS), then multivariate analysis was performed to identify independent prognostic indicators of poor survival. Prognostic models based on preoperative, postoperative, and both types of indicators were then constructed, and their predictive performance were evaluated using time-dependent receiver operating characteristic curves and the concordance index (C-index). Results PreLCR and PostLCR levels correlated with DFS and OS more strongly than other pre- and postoperative inflammatory indicators, respectively. Decreased PreLCR and PostLCR were independent prognostic factors for both DFS and OS, while HCC patients with decreased PreLCR and PostLCR had worse prognosis than patients with increased PreLCR and PostLCR. Patients into three groups based on their cut-off values of PreLCR and PostLCR, Kaplan–Meier survival analysis indicated that HCC patients with low PreLCR and PostLCR had the worst DFS and OS. The combined model showed better predictive performance at 1 and 3 years post-surgery than individual pre- and postoperative models, the American Joint Committee on Cancer/Tumor-Node-Metastasis (8th edition) staging system and the Barcelona Clinic Liver Cancer system. The combine model demonstrated a markedly superior C-index compared with the other models in DFS and OS. Conclusion Our study showed PreLCR and PostLCR are independent predictors of DFS and OS in HCC patients after partial hepatectomy. Models that include both PreLCR and PostLCR can predict prognosis better than well-established clinical staging systems.

show abstract

Section: Discussionmentioning

confidence: 99%

Combining Pre- and Postoperative Lymphocyte–C-Reactive Protein Ratios Can Better Predict Hepatocellular Carcinoma Prognosis After Partial Hepatectomy

Ni¹,

Zhan²,

Huang³

et al. 2022

JIR

View full text Add to dashboard Cite

show abstract

“…LCR has been shown to predict recurrence, prognosis, and postoperative morbidity in various malignancies [ 18 25 ]. It has also been shown to be superior to other inflammation-based markers for predicting the prognosis of patients with surgically resected HCC [ 14 15 16 ]. However, in the aforementioned studies, the AUC analysis of LCR showed poor prognostic performance, and AGR was not considered as a potential prognostic marker.…”

Section: Discussionmentioning

confidence: 99%

“…Lymphopenia is associated with poor host immunological competence in malignant disease and predicts oncologic outcomes [ 28 ]. Iseda et al [ 15 ] showed that patients with high LCR had fewer vessels encapsulating tumor clusters and higher intratumoral CD8 + T-cell counts than those with low LCR, suggesting that LCR is associated with TIME status. Conversely, serum CRP reflects a systemic inflammatory response.…”

Section: Discussionmentioning

confidence: 99%

“…Lymphocyte-to-CRP ratio (LCR) is a novel prognostic biomarker in colorectal cancer that has proved useful for perioperative management and postoperative follow-up [ 13 14 ]. LCR has also been shown to be an independent prognostic marker in patients with surgically resected HCC [ 15 16 17 ]. However, data on its ability to predict recurrence are lacking.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Preoperative lymphocyte-to-C-reactive protein ratio predicts hepatocellular carcinoma recurrence after surgery

et al. 2022

View full text Add to dashboard Cite

Purpose This study was performed to determine the prognostic value of lymphocyte-to-CRP ratio after curative resection for hepatocellular carcinoma. Methods Between July 2010 and October 2021, 173 consecutive patients (144 male, 29 female) who underwent surgical resection for pathologically confirmed hepatocellular carcinoma were included in this retrospective study. Cox regression analysis was used to evaluate the relationship between clinicopathological characteristics and recurrence-free survival (RFS) and overall survival (OS). A P-value of <0.05 was considered statistically significant. Results The patients (mean age, 71 years) were stratified into high (≥9,500, n = 108) and low (<9,500, n = 65) lymphocyte-to-CRP ratio groups. The low lymphocyte-to-CRP ratio group had significantly worse RFS and OS. Low lymphocyte-to-CRP ratio (hazard ratio [HR], 1.865; 95% confidence interval [CI], 1.176–2.960; P = 0.008), multiple tumors (HR, 3.333; 95% CI, 2.042–5.343; P < 0.001), and microvascular invasion (HR, 1.934; 95% CI, 1.178–3.184; P = 0.009) were independently associated with RFS, whereas low albumin-to-globulin ratio (HR, 2.270; 95% CI, 1.074–4.868; P = 0.032), α-FP of ≥25 ng/mL (HR, 2.187; 95% CI, 1.115–4.259; P = 0.023), and poor tumor differentiation (HR, 2.781; 95% CI, 1.041–6.692; P = 0.042) were independently associated with OS. Lymphocyte-to-CRP ratio had a higher area under the curve (0.635) than other inflammation-based markers (0.51–0.63). Conclusion Lymphocyte-to-CRP ratio is superior to other inflammation-based markers as a predictor of RFS in patients with surgically resected hepatocellular carcinoma.

show abstract

“…New models of risk based on inflammation, which include parameters such as CAR, platelets, the neutrophil to lymphocyte ratio, and LCR, better reflect inflammatory status. This was first reported in diseases such as COVID-19, cancer, CVD, or diabetic nephropathy [ 31 , 32 ]. CAR reflects both oxidative stress and antioxidant status and could be used as a surrogate inflammatory marker.…”

Section: Discussionmentioning

confidence: 99%

High-Risk Obesity Phenotypes: Target for Multimorbidity Prevention at the ROFEMI Study

Carretero-Gómez¹,

Pérez‐Martínez²,

Seguí-Ripoll³

et al. 2022

JCM

View full text Add to dashboard Cite

Background: Describe the profile of patients with obesity in internal medicine to determine the role of adiposity and related inflammation on the metabolic risk profile and, identify various “high-risk obesity” phenotypes by means of a cluster analysis. This study aimed to identify different profiles of patients with high-risk obesity based on a cluster analysis. Methods: Cross-sectional, multicenter project that included outpatients attended to in internal medicine. A total of 536 patients were studied. The mean age was 62 years, 51% were women. Patients were recruited from internal medicine departments over two weeks in November and December 2021 and classified into four risk groups according to body mass index (BMI) and waist circumference (WC). High-risk obesity was defined as BMI > 35 Kg/m2 or BMI 30–34.9 Kg/m2 and a high WC (>102 cm for men and >88 cm for women). Hierarchical and partitioning clustering approaches were performed to identify profiles. Results: A total of 462 (86%) subjects were classified into the high-risk obesity group. After excluding 19 patients missing critical data, two profiles emerged: cluster 1 (n = 396) and cluster 2 (n = 47). Compared to cluster 1, cluster 2 had a worse profile, characterized by older age (77 ± 16 vs. 61 ± 21 years, p < 0.01), a Charlson Comorbidity Index > 3 (53% vs. 5%, p < 0.001), depression (36% vs. 19%, p = 0.008), severe disability (64% vs. 3%, p < 0.001), and a sarcopenia score ≥ 4 (79% vs. 16%, p < 0.01). In addition, cluster 2 had greater inflammation than cluster 1 (hsCRP: 5.8 ± 4.1 vs. 2.1 ± 4.5 mg/dL, p = 0.008). Conclusions: Two profiles of subjects with high-risk obesity were identified. Based on that, older subjects with obesity require measures that target sarcopenia, disability, psychological health, and significant comorbidities to prevent further health deterioration. Longitudinal studies should be performed to identify potential risk factors of subjects who progress from cluster 1 to cluster 2.

show abstract

Lymphocyte-to-C-reactive protein ratio as a prognostic factor for hepatocellular carcinoma

Cited by 37 publications

References 36 publications

Combining Pre- and Postoperative Lymphocyte–C-Reactive Protein Ratios Can Better Predict Hepatocellular Carcinoma Prognosis After Partial Hepatectomy

Combining Pre- and Postoperative Lymphocyte–C-Reactive Protein Ratios Can Better Predict Hepatocellular Carcinoma Prognosis After Partial Hepatectomy

Preoperative lymphocyte-to-C-reactive protein ratio predicts hepatocellular carcinoma recurrence after surgery

High-Risk Obesity Phenotypes: Target for Multimorbidity Prevention at the ROFEMI Study

Contact Info

Product

Resources

About