Lymphocytes and Neutrophil-to-Lymphocyte Ratio Variations After Selective Internal Radiation Treatment for HCC: A Retrospective Cohort Study

Estrade, Florian; Lescure, Céline; Muzellec, Léa; Pedrono, Maud; Palard, Xavier; Pracht, Marc; Sourd, Samuel Le; Rolland, Yan; Uguen, Thomas; Garin, Étienne; Edeline, Julien

doi:10.1007/s00270-020-02467-9

Cited by 14 publications

(15 citation statements)

References 18 publications

(17 reference statements)

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“…Studies have shown that tumor-specific cytotoxic T cells in primary liver cancer are accompanied by high expression of inhibitory immune checkpoints such as CTLA4, PD-L1 and TIM3 [ 22 – 24 ], which makes T cells unable to effectively recognize tumor cells and lead to immune escape [ 25 ]. Tumor-infiltrating lymphocytes can reflect the immune response status of patients [ 26 ], however, the level of lymphocytes in peripheral blood plays a role in this as well [ 27 ]. Peripheral blood is easy to obtain, with low cost and can be continuously monitored.…”

Section: Discussionmentioning

confidence: 99%

Predictive potential of Nomogram based on GMWG for patients with hepatocellular carcinoma after radical resection

Ren

Chen

et al. 2021

BMC Cancer

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Background Since it’s a challenging task to precisely predict the prognosis of patients with hepatocellular carcinoma (HCC). We developed a nomogram based on a novel indicator GMWG [(Geometric Mean of gamma-glutamyltranspeptidase (GGT) and white blood cell (WBC)] and explored its potential in the prognosis for HCC patients. Methods The patients enrolled in this study were randomly assigned to training and validation cohorts. And we performed the Least Absolute Shrinkage and Selection Operator proportional hazards model (LASSO Cox) model with clinical characteristics, serum indexes, and novel GMWG. Multivariate analysis was performed to build a nomogram. The performance of the nomogram was evaluated by C-index, the area under the receiver operating characteristic curve (AUC), and the calibration curve. Kaplan-Meier curves showed discrimination of the nomogram. Clinical utility was assessed by decision curve analysis (DCA). The discrimination ability of the nomogram was determined by the net reclassification index (NRI). Results The geometric mean of GGT and white WBC count (GMWG), neutrophil to lymphocyte ratio (NLR), and tumor size were significantly associated with the overall survival (OS). The variables above were used to develop the nomogram. The indexes of nomogram were 0.70 and 071 in the training or validation cohort, respectively. AUC of 1-, 3- and 5-year OS showed satisfactory accuracy as well. The calibration curve showed agreement between the ideal and predicted values. Kaplan-Meier curves based on the overall survival (OS) and disease-free survival (DFS) showed significant differences between nomogram predictive low and high groups. DCA showed clinical utilities while NRI showed discrimination ability in both training or validation cohort. Conclusions GMWG might be a potential prognostic indicator for patients with HCC. The nomogram containing GMWG also showed satisfaction prediction capacity.

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Section: Discussionmentioning

confidence: 99%

Predictive potential of Nomogram based on GMWG for patients with hepatocellular carcinoma after radical resection

Ren

Chen

et al. 2021

BMC Cancer

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“…Recently, researchers have suggested that neutrophil to lymphocyte ratio (NLR) is associated with tumor response and progression-free survival in HCCs after treatment [28,29].…”

Section: Discussionmentioning

confidence: 99%

Does Neutrophil to Lymphocyte Ratio Have a Role in Identifying Cytokeratin 19-Expressing Hepatocellular Carcinoma?

Lee

Lin

et al. 2021

JPM

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Background: Cytokeratin 19-positive (CK19(+)) hepatocellular carcinomas (HCC) are generally associated with poor prognosis after hepatectomy. It is typically detected from postoperative immunochemistry. We have analyzed several clinically available biomarkers, in particular, neutrophil to lymphocyte ratio (NLR) and aim to develop a panel of biomarkers in identifying CK19 expression in (HCC) preoperatively. Methods: We retrospectively reviewed 36 HCC patients who underwent liver resections during January 2017 to March 2018 in Chang Gung Memorial Hospital. Patients were grouped based on the status of CK19 expression and their baseline characteristics, perioperative and oncologic outcomes were compared. Novel biomarkers including NLR, alpha-fetoprotein (AFP), carcinoembryonic antigen (CEA) and uric acid were analyzed and correlated with CK19 expression. Results: NLR is highly associated with CK19 expression. NLR alone gave an AUROC of 0.728 (p-value = 0.043), higher than AFP, CEA or tumor size alone. NLR when combined with AFP, CEA and uric acid, gave an AUROC as high as 0.933 (p-value = 0.004). Conclusion: The current study demonstrated the predictive capability of NLR in combination with AFP, CEA and uric acid for CK19 expression in HCC patients preoperatively. Further prospective, large-scale studies are warranted to validate our findings.

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“… 3–5 While several studies have focused on tumor absorbed dose and how it relates to clinical outcomes, 3 , 6 , 7 relatively few studies have evaluated the relationship of normal liver dose (NLD) to toxicities. 5 , 8 …”

Section: Introductionmentioning

confidence: 99%

“… 9 Given this, it is not surprising that several studies have documented lymphocyte reduction following TARE. 8 , 10–14 However, there is still lack of detailed understanding of the dynamic changes in lymphocytes, how the changes relate to dose distribution, and if they impact survival. These questions are of particular importance for several reasons.…”

Section: Introductionmentioning

confidence: 99%

Dynamic Lymphocyte Changes Following Transarterial Radioembolization: Association with Normal Liver Dose and Effect on Overall Survival

Young¹,

Ragulojan²,

Chen³

et al. 2022

JHC

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Objective To evaluate the dynamic changes of lymphocytes following transarterial radioembolization (TARE) for hepatocellular carcinoma (HCC) and their relationship to normal liver dose (NLD). Materials and Methods A total of 93 patients who underwent 102 treatments were retrospectively reviewed. Absolute lymphocyte counts pretreatment and at 1, 3, 6, and 12 months were evaluated. Kaplan–Meier, Spearman correlation, receiver operating characteristic (ROC) curve, and area under the curve (AUC) analyses were performed. Results The mean absolute lymphocyte count at baseline was 1.25 ± 0.79 10 3 /µL which was significantly greater than 1 (0.71 ± 0.47 10 3 /µL, p <0.0001), 3 (0.79 ± 0.77 10 3 /µL, p =0.0003), and 6 (0.81 ± 0.44 10 3 /µL, p =0.0001) months, but not significantly different than 12 (0.92 ± 0.8 10 3 /µL, p =0.12) months post treatment. There was a modest negative correlation between NLD and lymphocyte count at 1 month (rho= −0.216, p =0.03), which strengthened at 3 months post treatment (rho= −0.342, p =0.008). AUC of ROC analysis between absolute lymphocyte count ≤1 10 3 /µL or >1 10 3 /µL at 1, 3, 6, and 12 months post treatment was 0.625, 0.676, 0.560, and 0.794, respectively. Univariate analysis of overall survival when separating patients by a lymphocyte count of ≤1 10 3 /µL and >1 10 3 /µL demonstrated a significant difference at 1 (HR: 0.56, 95% CI: 0.33–0.95, p =0.03), 3 (HR: 0.41, 95% CI: 0.18–0.94, p =0.035) and 6 (HR: 0.36, 95% CI: 0.17–0.77, p =0.008) months post treatment, but not pretreatment or at 12 months. Conclusion NLD may correlate with lymphocyte depression at 1 and 3 months and lymphopenia may portend a worse overall survival in the post treatment setting.

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Lymphocytes and Neutrophil-to-Lymphocyte Ratio Variations After Selective Internal Radiation Treatment for HCC: A Retrospective Cohort Study

Cited by 14 publications

References 18 publications

Predictive potential of Nomogram based on GMWG for patients with hepatocellular carcinoma after radical resection

Predictive potential of Nomogram based on GMWG for patients with hepatocellular carcinoma after radical resection

Does Neutrophil to Lymphocyte Ratio Have a Role in Identifying Cytokeratin 19-Expressing Hepatocellular Carcinoma?

Dynamic Lymphocyte Changes Following Transarterial Radioembolization: Association with Normal Liver Dose and Effect on Overall Survival

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