Clinical importance of the absolute count of neutrophils, lymphocytes, monocytes, and platelets in newly diagnosed hepatocellular carcinoma

Abstract

Although several studies have confirmed the clinical significance of the systemic inflammation markers in hepatocellular carcinoma (HCC), evaluating the clinical significance of each blood cell remains to be conducted. We aimed to evaluate the clinical importance of absolute counts of blood cells in the overall survival (OS) of patients with newly diagnosed HCC. We recruited patient cohorts from the prospective registry of newly diagnosed and previously untreated HCC at Samsung Medical Center, which included a training set of 6619 patients (2005–2013) and a validation set of 2084 patients (2014–2016). More than three-quarters of all patients had hepatitis B virus (HBV)-related HCC in both training and validation sets. The optimal cutoff values of the absolute counts of neutrophils, lymphocytes, monocytes, and platelets were 3917, 488, 1379, and 22,100, respectively, which correlated significantly with OS. The absolute blood cell counts categorized by each optimal cutoff value significantly correlated with liver function status determined by Child–Pugh class/albumin-bilirubin (ALBI) grade and the HCC burden determined by several staging systems/portal vein tumor thrombosis. Although the prognostic model based on these blood cells (ABC model) showed a lower prognostic ability than the Japan Integrated Staging or ALBI-T staging systems, it provided significant discrimination of survival in the subgroups of ALBI-T and showed the highest prognostic ability in the present study in the training and validation sets. Absolute counts of blood cells are independently associated with OS, though it is also significantly associated with liver function and tumor burden in newly diagnosed HCC.

Prognostic significance of albumin–bilirubin score in patients with unresectable hepatocellular carcinoma undergoing combined immunotherapy and radiotherapy

“…The baseline neutrophil–lymphocyte ratio (NLR) and lymphocyte counts have been reported to correlate with survival among patients with HCC in several studies 35–37 . However, we found no statistically significant differences when analysing the influence of NLR on PFS or OS.…”

“…These results imply The baseline neutrophil-lymphocyte ratio (NLR) and lymphocyte counts have been reported to correlate with survival among patients with HCC in several studies. [35][36][37] However, we found no statistically significant differences when analysing the influence of NLR on PFS or OS. Additionally, lymphocyte count was associated with OS only in univariate analyses (and not multivariate analyses).…”

The value of preoperative systemic inflammatory response index (SIRI) combined with albumin-bilirubin grading (ALBI) in predicting early recurrence following curative resection of single hepatocellular carcinoma

“…In recent years, an increasing number of studies have demonstrated that in ammation plays an important role in the occurrence, development, and metastasis of malignant tumors [13,25,31]. The potential mechanisms could be that neutrophils are mainly concentrated in the peritumoral matrix of liver cancer tissues, [32] and can release angiogenic factors and in ammatory mediators, such as interleukin-1 β (IL-1β), interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α), and reactive oxygen species (ROS).…”

The Value of Preoperative Systemic Inflammatory Response index (SIRI) Combined with Albumin-Bilirubin Grading (ALBI) in Predicting Early Recurrence Following Curative Resection of Single Hepatocellular Carcinoma

“…In recent years, an increasing number of studies have demonstrated that in ammation plays an important role in the occurrence, development, and metastasis of malignant tumors [13,25,31]. The potential mechanisms could be that neutrophils are mainly concentrated in the peritumoral matrix of liver cancer tissues, [32] and can release angiogenic factors and in ammatory mediators, such as interleukin-1 β (IL-1β), interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α), and reactive oxygen species (ROS).…”

“…The potential mechanisms could be that neutrophils are mainly concentrated in the peritumoral matrix of liver cancer tissues, [32] and can release angiogenic factors and in ammatory mediators, such as interleukin-1 β (IL-1β), interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α), and reactive oxygen species (ROS). In addition, neutrophils can inhibit the cytolytic activity of immune cells, which promotes the proliferation and metastasis of cancer cells [5,9,10,31,33]. Neutrophils and tumor-associated macrophages modulate the suppression of anti-tumor immunity by inhibiting the immune function of natural killer cells and T cells, leading to malignant progression [5].…”