关键词:

中性粒细胞/淋巴细胞比值, 肝细胞癌, 经导管动脉化疗栓塞术, 急性肝功能恶化

Abstract:

Objective To investigate the predictive value of neutrophil/lymphocyte ratio and its dynamic change on the risk of acute liver function deterioration （ALFD）after transcatheter arterial chemoembolization （TACE）in patients with hepatocellular carcinoma（HCC）. Methods Clinical data of 131 patients who met the inclusion criteria in our hospital in 2021 were retrospectively analyzed. The ROC curve was drawn to determine the best cut⁃off point of NLR and △NLR. Univariate and multivariate logistic regression analysis were used to analyze the clinical factors that may affect the risk of ALFD in patients. Results The optimal cut⁃off point of NLR and △NLR for predicting the risk of postoperative ALFD were 3.81 and 4.45，respectively. Univariate analysis showed that BMI（P = 0.022），portal vein tumor thrombus（P = 0.004），number of interventions（P = 0.020），tumor size （P = 0.002），activated partial thromboplastin time（P = 0.036），total bilirubin（P = 0.031），alkaline phosphatase （P = 0.010），AST/ALT（P = 0.029）），NLR（P = 0.042）and ΔNLR（P = 0.039）may be associated with the risk of ALFD. Multivariate analysis showed that portal vein tumor thrombus（OR = 3.221），activated partial prothrombin time（OR = 1.145），NLR（≥ 3.81）（OR = 1.044），and △NLR（≥ 4.45）（OR = 3.159）were independent risk factors for ALFD（all P < 0.05）. Patients were divided into four groups according to the cut⁃off value. The risk of ALFD in group C（OR = 3.231，95%CI：1.292 ~ 8.076，P = 0.012）and D（OR = 5.400，95%CI：1.610 ~ 18.113， P = 0.006）was higher than that in group A. Conclusion The combination of NLR ≥ 3.81 and △NLR ≥ 4.45 is an independent predictor of ALFD risk.

Key words:

neutrophil/lymphocyte ratio, hepatocellular carcinoma, transcatheter arterial chemoembo? lization, acute liver function deterioration