TY - JOUR
T1 - Prognostic significance of preoperative aspartate aminotransferase to neutrophil ratio index in patients with hepatocellular carcinoma after hepatic resection
AU - Ji, Fei
AU - Fu, Shunjun
AU - Guo, Zhiyong
AU - Pang, Hui
AU - Chen, Dubo
AU - Wang, Xiaoping
AU - Ju, Weiqiang
AU - Wang, Dongping
AU - He, Xiaoshun
AU - Hua, Yunpeng
AU - Peng, Baogang
N1 - Funding Information:
This study was supported by the National High Technology Research and Development Program of China (863 Program) (2012AA021007 & 2012AA021008), the Research Fund for the Doctoral Program of Higher Education of China by Ministry of Education (20110171120077), the National Natural Science Foundation of China (81201918, 81373156 and 81471583), the Special Fund for Science Research by Ministry of Health (201302009), the Key Clinical Specialty Construction Project of National Health and Family Planning Commission of the People's Republic of China, the Guangdong Provincial Key Laboratory Construction Projection on Organ Donation and Transplant Immunology (2013A061401007), Guangdong Provincial international Cooperation Base of Science and Technology (Organ Transplantation) (2015B050501002), Pearl River Nova Program of Guangzhou (201506010014), and Guangdong Provincial Natural Science Funds for Distinguished Young Scholars (2015A030306025). Science and Technology Project of Guangdong Province (2012B031800099), the Scientific Research Foundation for the Returned Overseas Chinese Scholars, State Education Ministry (2015, NO.311). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
PY - 2016
Y1 - 2016
N2 - Objectives: Various inflammation-based prognostic scores have been associated with poor survival in patients with hepatocellular carcinoma (HCC), and neutrophils display important roles. However, few studies have illuminated the relationship between preoperative aspartate aminotransferase (AST) to neutrophil ratio index (ANRI) and poor prognosis of HCC. We aimed to clarify the prognostic value of ANRI and evaluate the ability of different inflammation-based prognostic scores such as ANRI, AST to lymphocyte ratio index (ALRI), AST to platelet count ratio index (APRI), neutrophil-lymphocyte ratio index (NLR), and platelet-lymphocyte ratio index (PLR). Methods: Data were collected retrospectively from 303 patients who underwent curative resection for HCC. Preoperative ANRI, ALRI, APRI, NLR, PLR and clinicopathological variables were analyzed. Univariate, multivariate and Kaplan-Meier analyses were performed to identify the predictive value of the above factors for disease-free survival (DFS) and overall survival (OS). Results: ANRI was correlated with presence of HBsAg, AST, presence of cirrhosis, tumor size, PVTT, cancer of the liver Italian program (CLIP) score, recurrence. Univariate analysis showed ANRI, ALRI, APRI, NLR, PLR were significantly associated with DFS and OS in HCC patients with curative resection. After multivariate analysis, ANRI was demonstrated to be superior to ALRI, APRI, NLR, PLR, which were independently correlated with DFS and OS. Survival analysis showed that preoperative ANRI > 7.8 predicted poor prognosis of patients with HCC after hepatectomy. preoperative ANRI also showed different prognostic value in various subgroups of HCC. Furthermore, the predictive range was expanded by the combination of ANRI and NLR. Conclusions: preoperative ANRI is an independent effective predictor of prognosis for patients with HCC, higher levels of ANRI predict poorer outcomes and the combining ANRI and NLR increases the prognostic accuracy of testing.
AB - Objectives: Various inflammation-based prognostic scores have been associated with poor survival in patients with hepatocellular carcinoma (HCC), and neutrophils display important roles. However, few studies have illuminated the relationship between preoperative aspartate aminotransferase (AST) to neutrophil ratio index (ANRI) and poor prognosis of HCC. We aimed to clarify the prognostic value of ANRI and evaluate the ability of different inflammation-based prognostic scores such as ANRI, AST to lymphocyte ratio index (ALRI), AST to platelet count ratio index (APRI), neutrophil-lymphocyte ratio index (NLR), and platelet-lymphocyte ratio index (PLR). Methods: Data were collected retrospectively from 303 patients who underwent curative resection for HCC. Preoperative ANRI, ALRI, APRI, NLR, PLR and clinicopathological variables were analyzed. Univariate, multivariate and Kaplan-Meier analyses were performed to identify the predictive value of the above factors for disease-free survival (DFS) and overall survival (OS). Results: ANRI was correlated with presence of HBsAg, AST, presence of cirrhosis, tumor size, PVTT, cancer of the liver Italian program (CLIP) score, recurrence. Univariate analysis showed ANRI, ALRI, APRI, NLR, PLR were significantly associated with DFS and OS in HCC patients with curative resection. After multivariate analysis, ANRI was demonstrated to be superior to ALRI, APRI, NLR, PLR, which were independently correlated with DFS and OS. Survival analysis showed that preoperative ANRI > 7.8 predicted poor prognosis of patients with HCC after hepatectomy. preoperative ANRI also showed different prognostic value in various subgroups of HCC. Furthermore, the predictive range was expanded by the combination of ANRI and NLR. Conclusions: preoperative ANRI is an independent effective predictor of prognosis for patients with HCC, higher levels of ANRI predict poorer outcomes and the combining ANRI and NLR increases the prognostic accuracy of testing.
KW - Aspartate aminotransferase to neutrophil ratio index
KW - Biomarkers
KW - Hepatocellular carcinoma
KW - Prognosis
KW - Systemic immune-inflammation
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U2 - 10.18632/oncotarget.10848
DO - 10.18632/oncotarget.10848
M3 - Article
C2 - 27472390
AN - SCOPUS:84995403863
SN - 1949-2553
VL - 7
SP - 72276
EP - 72289
JO - Oncotarget
JF - Oncotarget
IS - 44
ER -