Prognostic value of combined preoperative fibrinogen and neutrophil-lymphocyte ratio in patients with hepatocellular carcinoma after liver transplantation

Shun Jun Fu, Fei Ji, Ming Han, Mao Gen Chen, Xiao Ping Wang, Wei Qiang Ju, Qiang Zhao, Lin Wei Wu, Qing Qi Ren, Zhi Yong Guo, Dong Ping Wang, Xiao Feng Zhu, Yi Ma, Xiao Shun He

Research output: Contribution to journalArticlepeer-review

16 Scopus citations

Abstract

Objectives: Elevated plasma fibrinogen (Fib) correlated with patient's prognosis in several solid tumors. However, few studies have illuminated the relationship between preoperative Fib and prognosis of HCC after liver transplantation. We aimed to clarify the prognostic value of Fib and whether the prognostic accuracy can be enhanced by the combination of Fib and neutrophil-lymphocyte ratio (NLR). Results: Fib was correlated with Child-pugh stage, alpha-fetoprotein (AFP), size of largest tumor, macro- and micro-vascular invasion. Univariate analysis showed preoperative Fib, AFP, NLR, size of largest tumor, tumor number, macro- and microvascular invasion were significantly associated with disease-free survival (DFS) and overall survival (OS) in HCC patients with liver transplantation. After multivariate analysis, only Fib and macro-vascular invasion were independently correlated with DFS and OS. Survival analysis showed that preoperative Fib > 2.345 g/L predicted poor prognosis of patients HCC after liver transplantation. Preoperative Fib showed prognostic value in various subgroups of HCC. Furthermore, the predictive range was expanded by the combination of Fib and NLR. Materials and Methods: Data were collected retrospectively from 130 HCC patients who underwent liver transplantation. Preoperative Fib, NLR and clinicopathologic variables were analyzed. The survival analysis was performed by the Kaplan-Meier method, and compared by the log-rank test. Univariate and multivariate analyses were performed to identify the prognostic factors for DFS and OS. Conclusions: Preoperative Fib is an independent effective predictor of prognosis for HCC patients, higher levels of Fib predict poorer outcomes and the combination of Fib and NLR enlarges the prognostic accuracy of testing.

Original languageEnglish (US)
Pages (from-to)4301-4312
Number of pages12
JournalOncotarget
Volume8
Issue number3
DOIs
StatePublished - 2017

Keywords

  • Fibrinogen
  • Hepatocellular carcinoma
  • Liver transplantation
  • Neutrophil-lymphocyte ration
  • Prognosis

ASJC Scopus subject areas

  • Oncology

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