Neutrophil to lymphocyte and platelet to lymphocyte ratios as biomarkers to predict relapse and survival in posthepatectomy HBV-related hepatocellular carcinoma: a meta-analysis and preliminary immune perspective

Abstract

Background: Hepatitis B virus (HBV) infection represents the major etiology of hepatocellular carcinoma (HCC) and results in poor outcomes. Accumulating evidence suggests that composite immune cell-based biomarkers such as neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR) have prognostic value in postoperative HCC patients. However, due to the complexity, differential etiology, and the presence of variable confounding factors in different studies, the relationship between these markers with clinical outcomes in HBV-related posthepatectomy HCC is unclear from an immune perspective. Thus, this meta-analysis was conducted to determine NLR and PLR and assess their relation to overall survival (OS) and recurrence-free survival (RFS) in patients with post-hepatectomy HCC with HBV infection. Methods:The databases PubMed, Embase, Scopus, and Cochrane Library were searched using relevant keywords. We included studies which compared the outcomes of RFS and OS between different levels of NLR and PLR in HBV-related HCC patients who had undergone hepatectomy. Hazard ratios (HRs) and their 95% confidence intervals (CIs) were considered as effective measures and were calculated by a pooled analysis. Evidence supporting the association of neutrophils, platelets, and lymphocytes with HBV infection, liver injury, and tumor progression in HCC was evaluated.Results: A total of 11 cohort studies with 5083 patients were included. Elevated NLR was significantly

A Novel Bifidobacterium/Klebsiella Ratio in Characterization Analysis of the Gut and Bile Microbiota of CCA Patients

“…Our study showed that CA199 was positively correlated with the NLR, PLR, and CRP but negatively correlated with the LMR and AAPR in CCA patients, so CA19-9 was correlated with markers of the systemic inflammatory response. High NLR, PLR, and CRP and low LMR and AARP were associated with advanced clinicopathological features and poor prognosis [ 5 – 7 ], which can be concluded that high levels of CA19-9 are associated with poor prognosis of CCA. At the same time, it was found in our study that CA19-9 was negatively correlated with the B/K ratio.…”

“…Inflammation is one of the hallmarks of cancer, and the pro-inflammatory effects of markers of systemic inflammatory response (SIR) that often reflect cancer immune status, such as plasma C-reactive protein (CRP), platelet to lymphocyte ratio (PLR), neutrophil to lymphocyte ratio (NLR), and lymphocyte to monocyte ratio (LMR), have been shown to play an important role in the development and progression of cancer. SIR is also a potential prognostic and/or predictive factor for hepatocellular carcinoma, colorectal cancer, and other malignancies [ 5 ]. The albumin-to-alkaline-phosphatase ratio (AAPR) is an index based on serum biomarkers, which may not only reflect the liver functional reserve but also be associated with inflammation and cancer cell proliferation [ 6 ].…”

“…The albumin-to-alkaline-phosphatase ratio (AAPR) is an index based on serum biomarkers, which may not only reflect the liver functional reserve but also be associated with inflammation and cancer cell proliferation [ 6 ]. High NLR, PLR, and CRP and low LMR and AARP were associated with advanced clinicopathological features and poor prognosis [ 5 – 7 ], but few studies had been done in CCA patients.…”

Construction and validation of a machine learning-based nomogram to predict the prognosis of HBV associated hepatocellular carcinoma patients with high levels of hepatitis B surface antigen in primary local treatment: a multicenter study

“…HBV-HCC prognosis is linked to several factors, including tumor burden, AFP, disease stage, ALBI, and NLR (18,19), and there are also nomograms about HBV-HCC (20)(21)(22). However, no nomogram for HCC patients with high HBsAg expression after local treatment has been available to our knowledge.…”

ACTB may serve as a predictive marker for the efficacy of lenvatinib in patients with HBV-related early-stage hepatocellular carcinoma following partial hepatectomy: a retrospective cohort study

“…At present, most of the studies on biomarkers related to the prediction of HCC targeted therapy are still in the preliminary stage, and more large samples and prospective clinical studies are needed to verify them. Currently, some studies have successively reported various substances or cells as biomarkers for predicting the prognosis of patients with HCC after liver resection ( 16 , 17 ), but there are few biomarkers that predict the efficacy of lenvatinib. In a random phase III non-inferiority trial (REFLECT), there was a trend that lower VEGF, angiogenin-2 (Ang-2), and FGF21 serum levels at baseline were associated with better outcomes with lenvatinib; early changes in rehabilitation and treatment of contaminated Soil in the treatment of HCC, Ang-2 levels, AFP response, baseline albumin bilirubin (ALBI) score, change in the ALBI score, neutrophil to lymphocyte and platelet to lymphocyte ratios were early predictors of objective response (OR) in patients with HCC undergoing lenvatinib treatment ( 17 , 18 ).…”