A combination of lymphocyte count and albumin concentration as a new prognostic index for Hepatocellular Carcinoma
Öz
Aim
The present study explores the prognostic significance of the lymphocytes (/L) × albumin (g/L) (LA) score and its relationship with the hepatocellular carcinoma.
Material and Methods
The study included patients who underwent curative surgery for hepatocellular carcinoma between January 2004 and November 2020. The LA score was calculated using the formula lymphocytes (/L)×albumin (g/L). The patients were subsequently divided into two as Group 1 (Low LA) and Group 2 (High LA). The two groups were compared for clinical characteristics as well as oncological follow-up outcomes.
Results
The study included 55 patients, who, based on an LA cut-off point of 4620, were divided into Group 1 (n=28) and Group 2 (n=27). The MELD score was higher in Group 1 (12 vs.9, p=0.022). The number of tumors, maximum tumor size and total tumor size were similar in both groups. At the last clinical follow-up, the mortality rate was 42.9% in Group 1 and 22.2% in Group 2. Recurrence rates were similar in both groups (42.9%vs.33.3% p=0.467), and total survival (126vs.164 months p=0.1) and disease-free survival (26 vs. 29 months p=0.926) were also similar.
Conclusion
The use of the composite LA index – an indicator of immunonutritional status as a prognostic marker may not be significant in HCC patients undergoing curative resection.
Anahtar Kelimeler
Carcinoma Hepatocellular Immunity Lymphocytes Nutritional Status Serum Albumin.
Etik Beyan
This study is authorized by the local ethics committee at Cukurova University (Approval Date: 03.12.2021, Registry No: 117/7)
Kaynakça
- Chen, X.-X., Zhao, S.-T., Yang, X.-M., He, S.-C., & Qian, F.-H. (2023). Additional diagnostic value of the monocyte to red blood cell count ratio and the product of lymphocyte count and albumin concentration in lung cancer management. Oncology Letters, 25(4), 1-9.
- Clancy, E. (2023). ACS Report Shows Prostate Cancer on the Rise, Cervical Cancer on the Decline. Renal & Urology News, NA-NA.
- De Lorenzo, S., Tovoli, F., Barbera, M. A., Garuti, F., Palloni, A., Frega, G., Garajovà, I., Rizzo, A., Trevisani, F., & Brandi, G. (2018). Metronomic capecitabine vs. best supportive care in Child-Pugh B hepatocellular carcinoma: a proof of concept. Scientific Reports, 8(1), 9997.
- European Association For The Study Of The Liver, & European Organisation For Research And Treatment Of Cancer (2012). EASL-EORTC clinical practice guidelines: management of hepatocellular carcinoma. Journal of hepatology, 56(4), 908–943. https://doi.org/10.1016/j.jhep.2011.12.001
- Harimoto, N., Shirabe, K., Yamashita, Y., Ikegami, T., Yoshizumi, T., Soejima, Y., Ikeda, T., Maehara, Y., Nishie, A., & Yamanaka, T. (2013). Sarcopenia as a predictor of prognosis in patients following hepatectomy for hepatocellular carcinoma. Journal of British Surgery, 100(11), 1523-1530.
- Harimoto, N., Yoshizumi, T., Inokuchi, S., Itoh, S., Adachi, E., Ikeda, Y., Uchiyama, H., Utsunomiya, T., Kajiyama, K., & Kimura, K. (2018). Prognostic significance of preoperative controlling nutritional status (CONUT) score in patients undergoing hepatic resection for hepatocellular carcinoma: a multi-institutional study. Annals of surgical oncology, 25, 3316-3323.
- Harimoto, N., Yoshizumi, T., Sakata, K., Nagatsu, A., Motomura, T., Itoh, S., Harada, N., Ikegami, T., Uchiyama, H., & Soejima, Y. (2017). Prognostic significance of preoperative controlling nutritional status (CONUT) score in patients undergoing hepatic resection for hepatocellular carcinoma. World journal of surgery, 41, 2805-2812.
- Howell, J. A., Pinato, D. J., Ramaswami, R., Arizumi, T., Ferrari, C., Gibbin, A., Burlone, M. E., Guaschino, G., Toniutto, P., & Black, J. (2017). Integration of the cancer-related inflammatory response as a stratifying biomarker of survival in hepatocellular carcinoma treated with sorafenib. Oncotarget, 8(22), 36161.
- Imai, D., Maeda, T., Shimokawa, M., Wang, H., Yoshiya, S., Takeishi, K., Itoh, S., Harada, N., Ikegami, T., & Yoshizumi, T. (2020). Prognostic nutritional index is superior as a predictor of prognosis among various inflammation‐based prognostic scores in patients with hepatocellular carcinoma after curative resection. Hepatology Research, 50(1), 101-109.
- Jia, X., Liu, J., Gao, Y., Huang, Y., & Du, Z. (2014). Diagnosis accuracy of serum glypican-3 in patients with hepatocellular carcinoma: a systematic review with meta-analysis. Archives of medical research, 45(7), 580-588.
- Johnson, P. J., Berhane, S., Kagebayashi, C., Satomura, S., Teng, M., Reeves, H. L., O'Beirne, J., Fox, R., Skowronska, A., & Palmer, D. (2015). Assessment of liver function in patients with hepatocellular carcinoma: a new evidence-based approach—the ALBI grade. Journal of Clinical Oncology, 33(6), 550.
- Mantovani, A., Allavena, P., Sica, A., & Balkwill, F. (2008). Cancer-related inflammation. nature, 454(7203), 436-444.
- Mazzaferro, V., Regalia, E., Doci, R., Andreola, S., Pulvirenti, A., Bozzetti, F., Montalto, F., Ammatuna, M., Morabito, A., & Gennari, L. (1996). Liver transplantation for the treatment of small hepatocellular carcinomas in patients with cirrhosis. New England Journal of Medicine, 334(11), 693-700.
- Nault, J.-C., Sutter, O., Nahon, P., Ganne-Carrié, N., & Séror, O. (2018). Percutaneous treatment of hepatocellular carcinoma: state of the art and innovations. Journal of hepatology, 68(4), 783-797.
- Onodera, T., Goseki, N., & Kosaki, G. (1984). Prognostic nutritional index in gastrointestinal surgery of malnourished cancer patients. Nihon geka gakkai zasshi, 85(9), 1001-1005.
- Rizzo, A., & Brandi, G. (2021). Biochemical predictors of response to immune checkpoint inhibitors in unresectable hepatocellular carcinoma. Cancer treatment and research communications, 27, 100328.
- Rizzo, A., Dadduzio, V., Ricci, A. D., Massari, F., Di Federico, A., Gadaleta-Caldarola, G., & Brandi, G. (2022). Lenvatinib plus pembrolizumab: the next frontier for the treatment of hepatocellular carcinoma? Expert opinion on investigational drugs, 31(4), 371-378.
- Roxburgh, C. S., & McMillan, D. C. (2010). Role of systemic inflammatory response in predicting survival in patients with primary operable cancer. Future oncology, 6(1), 149-163.
- Sung, H., Ferlay, J., Siegel, R. L., Laversanne, M., Soerjomataram, I., Jemal, A., & Bray, F. (2021). Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA: a cancer journal for clinicians, 71(3), 209-249.
- Takagi, K., Yagi, T., Umeda, Y., Shinoura, S., Yoshida, R., Nobuoka, D., Kuise, T., Araki, H., & Fujiwara, T. (2017). Preoperative controlling nutritional status (CONUT) score for assessment of prognosis following hepatectomy for hepatocellular carcinoma. World journal of surgery, 41(9), 2353-2360.
- Tanio, A., Saito, H., Uejima, C., Takaya, S., Yamamoto, M., Tokuyasu, N., Sakamoto, T., Honjo, S., Ashida, K., & Fujiwara, Y. (2019). A prognostic index for colorectal cancer based on preoperative absolute lymphocyte, monocyte, and neutrophil counts. Surgery today, 49, 245-253.
- Uchinaka, E., Amisaki, M., Morimoto, M., Tokuyasu, N., Sakamoto, T., Honjo, S., Saito, H., & Fujiwara, Y. (2018). Utility and limitation of preoperative neutrophil lymphocyte ratio as a prognostic factor in hepatocellular carcinoma. Yonago acta medica, 61(4), 197-203.
- Villanueva, A., Minguez, B., Forner, A., Reig, M., & Llovet, J. M. (2010). Hepatocellular carcinoma: novel molecular approaches for diagnosis, prognosis, and therapy. Annual review of medicine, 61, 317-328.
- Voron, T., Tselikas, L., Pietrasz, D., Pigneur, F., Laurent, A., Compagnon, P., Salloum, C., Luciani, A., & Azoulay, D. (2015). Sarcopenia impacts on short-and long-term results of hepatectomy for hepatocellular carcinoma. Annals of surgery, 261(6), 1173-1183.
- Yamamoto, T., Kawada, K., Hida, K., Matsusue, R., Itatani, Y., Mizuno, R., Yamaguchi, T., Ikai, I., & Sakai, Y. (2021). Combination of lymphocyte count and albumin concentration as a new prognostic biomarker for rectal cancer. Scientific reports, 11(1), 5027.
- Yang, T., Zhu, J., Zhao, L., Mai, K., Ye, J., Huang, S., & Zhao, Y. (2017). Lymphocyte to monocyte ratio and neutrophil to lymphocyte ratio are superior inflammation‐based predictors of recurrence in patients with hepatocellular carcinoma after hepatic resection. Journal of surgical oncology, 115(6), 718-728. Yang, Y., Ye, F., Xin, Y., Wang, Y., Li, X., Feng, D., Chen, Y., & Zhou, X. (2020). Prognostic significance of controlling nutritional status score-based nomogram for hepatocellular carcinoma within Milan criteria after radiofrequency ablation. Journal of Gastrointestinal Oncology, 11(5), 1024.
Hepatosellüler Karsinom için Yeni Bir Prognostik İndeks Olarak Lenfosit Sayısı ve Albümin Konsantrasyonunun Kombinasyonu
Öz
Amaç
Bu çalışmanın amacı, lenfosit (/L) × albümin (g/L) (LA) skorunun prognostik önemini ve hepatosellüler karsinom ile olan ilişkisini araştırmaktır.
Gereç ve Yöntemler
Çalışma, Ocak 2004 ile Kasım 2020 arasında hepatosellüler karsinoma için küratif cerrahi yapılan hastaları kapsamaktadır. Lenfosit-Albumün(LA) skoru, lenfosit (/L)×albümin (g/L) formülü kullanılarak hesaplanmıştır. Hastalar daha sonra Düşük LA (Grup 1) ve Yüksek LA (Grup 2) olmak üzere iki gruba ayrılmıştır. İki grup, klinik özellikler ve onkolojik takip sonuçları açısından karşılaştırılmıştır.
Sonuçlar
Çalışma, 4620 LA kesim noktasına göre Grup 1 (n=28) ve Grup 2 (n=27) olarak ayrılan 55 hastayı içermektedir. MELD skoru Grup 1'de daha yüksekti (12'ye karşı 9, p=0.022). Tümör sayısı, maksimum tümör boyutu ve toplam tümör boyutu her iki grupta benzerdi. Klinik takipte takipte, Grup 1'deki mortalite oranı %42.9 iken, Grup 2'de %22.2 idi. Nüks oranları her iki grupta benzer bulunmuştur (%42.9'a karşı %33.3, p=0.467), toplam sağkalım (126'ya karşı 164 ay, p=0.1) ve hastalıksız sağkalım (26'ya karşı 29 ay, p=0.926) oranları da benzer bulunmuştur.
Sonuç
Küratif rezeksiyon geçiren HCC hastalarında, immünonütrisyonel durumun bir göstergesi olan bileşik LA indeksinin prognostik bir işaretçi olarak kullanımı anlamlı olmayabilir.
Anahtar Kelimeler
Hepatosellüler karsinom İmmünite Lenfosit Nütrisyonel durum Serum Albumini
Kaynakça
- Chen, X.-X., Zhao, S.-T., Yang, X.-M., He, S.-C., & Qian, F.-H. (2023). Additional diagnostic value of the monocyte to red blood cell count ratio and the product of lymphocyte count and albumin concentration in lung cancer management. Oncology Letters, 25(4), 1-9.
- Clancy, E. (2023). ACS Report Shows Prostate Cancer on the Rise, Cervical Cancer on the Decline. Renal & Urology News, NA-NA.
- De Lorenzo, S., Tovoli, F., Barbera, M. A., Garuti, F., Palloni, A., Frega, G., Garajovà, I., Rizzo, A., Trevisani, F., & Brandi, G. (2018). Metronomic capecitabine vs. best supportive care in Child-Pugh B hepatocellular carcinoma: a proof of concept. Scientific Reports, 8(1), 9997.
- European Association For The Study Of The Liver, & European Organisation For Research And Treatment Of Cancer (2012). EASL-EORTC clinical practice guidelines: management of hepatocellular carcinoma. Journal of hepatology, 56(4), 908–943. https://doi.org/10.1016/j.jhep.2011.12.001
- Harimoto, N., Shirabe, K., Yamashita, Y., Ikegami, T., Yoshizumi, T., Soejima, Y., Ikeda, T., Maehara, Y., Nishie, A., & Yamanaka, T. (2013). Sarcopenia as a predictor of prognosis in patients following hepatectomy for hepatocellular carcinoma. Journal of British Surgery, 100(11), 1523-1530.
- Harimoto, N., Yoshizumi, T., Inokuchi, S., Itoh, S., Adachi, E., Ikeda, Y., Uchiyama, H., Utsunomiya, T., Kajiyama, K., & Kimura, K. (2018). Prognostic significance of preoperative controlling nutritional status (CONUT) score in patients undergoing hepatic resection for hepatocellular carcinoma: a multi-institutional study. Annals of surgical oncology, 25, 3316-3323.
- Harimoto, N., Yoshizumi, T., Sakata, K., Nagatsu, A., Motomura, T., Itoh, S., Harada, N., Ikegami, T., Uchiyama, H., & Soejima, Y. (2017). Prognostic significance of preoperative controlling nutritional status (CONUT) score in patients undergoing hepatic resection for hepatocellular carcinoma. World journal of surgery, 41, 2805-2812.
- Howell, J. A., Pinato, D. J., Ramaswami, R., Arizumi, T., Ferrari, C., Gibbin, A., Burlone, M. E., Guaschino, G., Toniutto, P., & Black, J. (2017). Integration of the cancer-related inflammatory response as a stratifying biomarker of survival in hepatocellular carcinoma treated with sorafenib. Oncotarget, 8(22), 36161.
- Imai, D., Maeda, T., Shimokawa, M., Wang, H., Yoshiya, S., Takeishi, K., Itoh, S., Harada, N., Ikegami, T., & Yoshizumi, T. (2020). Prognostic nutritional index is superior as a predictor of prognosis among various inflammation‐based prognostic scores in patients with hepatocellular carcinoma after curative resection. Hepatology Research, 50(1), 101-109.
- Jia, X., Liu, J., Gao, Y., Huang, Y., & Du, Z. (2014). Diagnosis accuracy of serum glypican-3 in patients with hepatocellular carcinoma: a systematic review with meta-analysis. Archives of medical research, 45(7), 580-588.
- Johnson, P. J., Berhane, S., Kagebayashi, C., Satomura, S., Teng, M., Reeves, H. L., O'Beirne, J., Fox, R., Skowronska, A., & Palmer, D. (2015). Assessment of liver function in patients with hepatocellular carcinoma: a new evidence-based approach—the ALBI grade. Journal of Clinical Oncology, 33(6), 550.
- Mantovani, A., Allavena, P., Sica, A., & Balkwill, F. (2008). Cancer-related inflammation. nature, 454(7203), 436-444.
- Mazzaferro, V., Regalia, E., Doci, R., Andreola, S., Pulvirenti, A., Bozzetti, F., Montalto, F., Ammatuna, M., Morabito, A., & Gennari, L. (1996). Liver transplantation for the treatment of small hepatocellular carcinomas in patients with cirrhosis. New England Journal of Medicine, 334(11), 693-700.
- Nault, J.-C., Sutter, O., Nahon, P., Ganne-Carrié, N., & Séror, O. (2018). Percutaneous treatment of hepatocellular carcinoma: state of the art and innovations. Journal of hepatology, 68(4), 783-797.
- Onodera, T., Goseki, N., & Kosaki, G. (1984). Prognostic nutritional index in gastrointestinal surgery of malnourished cancer patients. Nihon geka gakkai zasshi, 85(9), 1001-1005.
- Rizzo, A., & Brandi, G. (2021). Biochemical predictors of response to immune checkpoint inhibitors in unresectable hepatocellular carcinoma. Cancer treatment and research communications, 27, 100328.
- Rizzo, A., Dadduzio, V., Ricci, A. D., Massari, F., Di Federico, A., Gadaleta-Caldarola, G., & Brandi, G. (2022). Lenvatinib plus pembrolizumab: the next frontier for the treatment of hepatocellular carcinoma? Expert opinion on investigational drugs, 31(4), 371-378.
- Roxburgh, C. S., & McMillan, D. C. (2010). Role of systemic inflammatory response in predicting survival in patients with primary operable cancer. Future oncology, 6(1), 149-163.
- Sung, H., Ferlay, J., Siegel, R. L., Laversanne, M., Soerjomataram, I., Jemal, A., & Bray, F. (2021). Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA: a cancer journal for clinicians, 71(3), 209-249.
- Takagi, K., Yagi, T., Umeda, Y., Shinoura, S., Yoshida, R., Nobuoka, D., Kuise, T., Araki, H., & Fujiwara, T. (2017). Preoperative controlling nutritional status (CONUT) score for assessment of prognosis following hepatectomy for hepatocellular carcinoma. World journal of surgery, 41(9), 2353-2360.
- Tanio, A., Saito, H., Uejima, C., Takaya, S., Yamamoto, M., Tokuyasu, N., Sakamoto, T., Honjo, S., Ashida, K., & Fujiwara, Y. (2019). A prognostic index for colorectal cancer based on preoperative absolute lymphocyte, monocyte, and neutrophil counts. Surgery today, 49, 245-253.
- Uchinaka, E., Amisaki, M., Morimoto, M., Tokuyasu, N., Sakamoto, T., Honjo, S., Saito, H., & Fujiwara, Y. (2018). Utility and limitation of preoperative neutrophil lymphocyte ratio as a prognostic factor in hepatocellular carcinoma. Yonago acta medica, 61(4), 197-203.
- Villanueva, A., Minguez, B., Forner, A., Reig, M., & Llovet, J. M. (2010). Hepatocellular carcinoma: novel molecular approaches for diagnosis, prognosis, and therapy. Annual review of medicine, 61, 317-328.
- Voron, T., Tselikas, L., Pietrasz, D., Pigneur, F., Laurent, A., Compagnon, P., Salloum, C., Luciani, A., & Azoulay, D. (2015). Sarcopenia impacts on short-and long-term results of hepatectomy for hepatocellular carcinoma. Annals of surgery, 261(6), 1173-1183.
- Yamamoto, T., Kawada, K., Hida, K., Matsusue, R., Itatani, Y., Mizuno, R., Yamaguchi, T., Ikai, I., & Sakai, Y. (2021). Combination of lymphocyte count and albumin concentration as a new prognostic biomarker for rectal cancer. Scientific reports, 11(1), 5027.
- Yang, T., Zhu, J., Zhao, L., Mai, K., Ye, J., Huang, S., & Zhao, Y. (2017). Lymphocyte to monocyte ratio and neutrophil to lymphocyte ratio are superior inflammation‐based predictors of recurrence in patients with hepatocellular carcinoma after hepatic resection. Journal of surgical oncology, 115(6), 718-728. Yang, Y., Ye, F., Xin, Y., Wang, Y., Li, X., Feng, D., Chen, Y., & Zhou, X. (2020). Prognostic significance of controlling nutritional status score-based nomogram for hepatocellular carcinoma within Milan criteria after radiofrequency ablation. Journal of Gastrointestinal Oncology, 11(5), 1024.
Ayrıntılar
| Birincil Dil | İngilizce |
|---|---|
| Konular | Gastroenteroloji ve Hepatoloji |
| Bölüm | MAKALELER |
| Yazarlar | |
| Yayımlanma Tarihi | 30 Nisan 2024 |
| Gönderilme Tarihi | 2 Aralık 2023 |
| Kabul Tarihi | 10 Mart 2024 |
| Yayımlandığı Sayı | Yıl 2024 Cilt: 8 Sayı: 1 |
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