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Neutrophil‐to‐lymphocyte ratio predicts recurrence after radiofrequency ablation in hepatitis B virus infection
Author(s) -
Tajiri Kazuto,
Baba Hayato,
Kawai Kengo,
Minemura Masami,
Yasumura Satoshi,
Takahara Terumi,
Sugiyama Toshiro
Publication year - 2016
Publication title -
journal of gastroenterology and hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.214
H-Index - 130
eISSN - 1440-1746
pISSN - 0815-9319
DOI - 10.1111/jgh.13287
Subject(s) - medicine , gastroenterology , hepatocellular carcinoma , odds ratio , neutrophil to lymphocyte ratio , radiofrequency ablation , milan criteria , hepatitis c virus , population , hepatitis b virus , lymphocyte , ablation , virus , immunology , liver transplantation , transplantation , environmental health
Background and Aim: Radiofrequency ablation (RFA) is an established treatment for small hepatocellular carcinoma (HCC) wherein non‐recurrence is essential for long‐term survival. Recently, neutrophil‐to‐lymphocyte ratio (NLR), a marker of systemic inflammation that is associated with tumor‐associated macrophages (TAMs), was suggested to be a prognostic marker of HCC treated with RFA. Therefore, we evaluated predictive factors, including NLR, associated with recurrence after curative RFA. Methods: A total of 163 patients initially diagnosed with HCC and treated with RFA were enrolled. We retrospectively analyzed factors associated with recurrence and survival after RFA. Furthermore, TAMs were evaluated using surgically resected specimens. Results: Hepatitis C virus (HCV) infection was the most frequent cause of HCC in this population (111 cases, 68.1%), whereas hepatitis B virus (HBV) infection accounted for 26 cases (16.0%). Recurrence, mostly intrahepatic distant recurrence, was found in 101 cases (61.9%). Recurrence and posttreatment NLR were independent prognostic factors related to survival, and male sex, HCV infection, serum des‐ γ ‐carboxy prothrombin > 40 AU/L, and posttreatment NLR were associated with recurrence. Pretreatment NLR showed no association with recurrence, whereas posttreatment NLR showed prognostic value. Interestingly, pretreatment NLR > 2.5 was significantly associated with recurrence in HBV‐HCC patients (odds ratio 3.439, P = 0.037) not but HCV‐HCC (odds ratio 1.430, P = 0.17). Furthermore, TAMs were increased in the peripheral area of HCCs with HBV infection compared with those with HCV. Conclusions: Recurrence of HCC after RFA was strongly associated with survival. NLR is useful as a predictive marker of recurrence, especially in HBV‐HCC patients.