Negative Impact of Neutrophil-Lymphocyte Ratio on Outcome After Liver Transplantation for Hepatocellular Carcinoma

Abstract

Elevated NLR significantly increases the risk for tumor recurrence and recipient death. Preoperative NLR measurement may provide a simple method of identifying patients with poorer prognosis and act as an adjunct to Milan in determining, which patients benefit most from OLT.

Is the Neutrophil-Lymphocyte Ratio an Indicator of Progression in Patients with Benign Prostatic Hyperplasia?

“…The neutrophil-lymphocyte ratio (NLR) can be calculated easily from complete blood counts and is an easily accessible marker which indicates the state of inflammation in the body. Recently, the neutrophil-tolymphocyte ratio (NLR) was introduced as a potential biomarker to assess inflammation and to predict outcomes in cancer, cardiac and other disorders (Walsh et al, 2005;Nunez et al, 2008;Tamhane et al, 2008;Halazun et al, 2009;Celikbilek et al, 2013). We can obtain information about two different immune pathways from the NLR.…”

Predictive Role of the Neutrophil Lymphocyte Ratio for Invasion with Gestational Trophoblastic Disease

“…Previous studies reported different markersfrom the differantial white blood cellcount. NLR has been reported as predictive markers in outcomes of endometrial precancerous and cancerous lesions in patients with abnormal uterine bleeding, other cancers and coronary artery disease (Duffy et al, 2006;Halazun et al, 2009;Dirican et al, 2013;Karaman et al, 2013;Unal et al, 2013;Yucel et al, 2013;Acmaz et al, 2014).…”

Reply

“…While the Milan criteria are widely accepted despite having no specific tumor biology indices associated with them, many groups including our own have attempted to define markers of poor biology; however, none of these have been universally accepted or applied to organ allocation models. 3,4 Currently, it seems that lack of progression of tumor while waiting for a liver transplant, or successful down-staging of tumor, may be the best available biological marker, as demonstrated by the UCSF group and our article. 1,2,5 We agree that the development, and universal implementation of appropriate and reproducible biomarkers of tumor biology to allocation models of liver transplantation for HCC is required in order to optimize outcomes for HCC patients.…”

“…The investigators report that higher circulating and liver levels of miR-122 relate to spontaneous survival and contribute to regeneration and enhanced proliferation. These conclusions directly conflict with the well-established, replicated findings that miR-122 knockout mice and mice with deletions in miR-122 regulators, such as Dicer1, have enhanced levels of hepatocyte proliferation, 3 that the loss of miR-122 from hepatocytes results in reduced differentiation and enhanced proliferation, 4 and that the levels of miR-122 are decreased in liver, yet increased in blood, of rodent models of ALI. 5 Furthermore, we feel that robust conclusions cannot be based on liver miR-122 expression data from a very low number of patients (n 5 4 and n 5 6 for recovery and nonrecovery, respectively).…”