4.7 Article

Neutrophil-to-Apolipoprotein A1 Ratio Predicted Overall Survival in Hepatocellular Carcinoma Receiving Transarterial Chemoembolization

期刊

ONCOLOGIST
卷 26, 期 8, 页码 E1434-E1444

出版社

OXFORD UNIV PRESS
DOI: 10.1002/onco.13743

关键词

Hepatocellular carcinoma; Transarterial chemoembolization; Overall survival; Neutrophil‐ to‐ apolipoprotein A1 ratio; Polymorphonuclear myeloid‐ derived suppressor cells

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资金

  1. Guangzhou Science and Technology Project [201904010461]
  2. National Natural Science Foundation of China [81972677, 81871999]
  3. Natural Science Foundation of Guangdong [2019A1515012198, 2019A1515011187, 2017A030313537]
  4. Special Funds for Fundamental Research Fund of Sun Yat-sen University [19ykpy17]
  5. Shenzhen science and technology project [JCYJ20190809165813331]
  6. Guangdong High-Level Personnel of Special Support Program Outstanding Young Scholar in Science and Technology Innovation [2019TQ05Y266]

向作者/读者索取更多资源

This study confirmed NAR as an independent predictor for OS among patients with HCC receiving TACE, and highlighted the association of NAR with LOX-1(+) PMN-MDSC level. The integrated NAR-CLIP score showed superior predictive capacity compared to individual CLIP score in predicting survival at different time points.
Purpose The purpose of this study was to investigate the predictive capability of neutrophil-to-apolipoprotein A1 ratio (NAR) for predicting overall survival (OS) among patients with hepatocellular carcinoma (HCC) receiving transarterial chemoembolization (TACE). Patients and Methods We investigated the clinical features of 554 patients with HCC receiving TACE and assessed NAR's predictive value for OS with 222 patients (the discovery cohort) and 332 patients (the validation cohort). The association of NAR with circulation lectin-type oxidized low-density lipoprotein receptor-1-positive (LOX-1(+)) polymorphonuclear myeloid-derived suppressor cells (PMN-MDSCs) was illustrated. Results Multivariate Cox regression revealed that lymphocyte count; Tumor, Node, Metastasis (TNM) stage; and NAR were independent prognostic factors in the discovery cohort. The validation cohort confirmed the independent prognostic value of TNM stage and NAR. Patients with low NAR (<2.7) displayed significantly increased OS in the discovery cohort (59.8 months vs. 21 months), the validation group (38.0 months vs. 23.6 months), and the total cohort (44.1 months vs. 22.0 months). A Cox proportional hazards model was used to combine Cancer of the Liver Italian Program (CLIP) score with discretized NAR. C-index illustrated that NAR-integrated CLIP score was the best model compared with NAR and CLIP score. Furthermore, NAR-CLIP presented superior predictive capacity for 10-, 20-, 30-, 40-, 50-, and 60-month survival compared with CLIP score by survival receiver-operator characteristic analysis in the discovery cohort, validation cohort, and total cohort. NAR was significantly associated with LOX-1(+) PMN-MDSCs by linear regression. Conclusion This study identified NAR as an independent predictor for OS among patients with HCC receiving TACE. NAR reflected circulation LOX-1(+) PMN-MDSC level. Implications for Practice The present study identified neutrophil-to-apolipoprotein A1 ratio (NAR) as an independent predictor for overall survival among patients with hepatocellular carcinoma receiving transarterial chemoembolization. NAR reflected circulation level of lectin-type oxidized low-density lipoprotein receptor-1-positive polymorphonuclear myeloid-derived suppressor cells.

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