| Background : With the emergence of new pharmaceutical preparations and treatment methods in the field of medicine,malignant tumor,which was a deadly disease that people could not do,has gradually transformed into a chronic disease,and some diseases can even achieve complete remission or basic cured condition.However,based on the current basic national conditions of our country,the population base is relatively large,and the problems of population aging and low birthrate have gradually become prominent.In addition,the new coronavirus pneumonia epidemic has swept the world in recent years,which has caused serious problems to the normal daily life of ordinary people.no small impact.Moreover,the morbidity and mortality of malignant tumors in my country ranks first in the world,which may be related to the geographical characteristics of our country and the dietary habits of the population.Although the country has provided us with many methods and means for prevention and screening,my country is still a big country with hepatitis B,and the number of people infected with hepatitis B virus is relatively large.As we all know,liver cancer trilogy,hepatitis-cirrhosis-cancer.In recent years,the incidence of liver cancer in my country is still relatively high,and patients with liver cancer have almost no obvious clinical symptoms in the early stage,and they are already in the middle and late stages when obvious symptoms appear.The treatment effect of advanced liver cancer is poor.At present,the predictive role of some peripheral hematological indicators in malignant tumors has been recognized and accepted by everyone.predictors of prognosis.Perhaps they can be used as candidate indicators in clinical work,and can provide doctors with a moderate reference in the process of clinical diagnosis and treatment.Therefore,we can try to predict the prognosis of patients with liver cancer through some indicators in the patient’s peripheral blood,such as lymphocyte to monocyte ratio(LMR),aspartate aminotransferase to lymphocyte ratio(ALRI),these peripheral blood The indicators will be obtained as soon as the patient is admitted to the hospital,which is more convenient and accessible.Therefore,in this study,we mainly wanted to explore the relationship between the LMR value and ALRI value of different patients with primary liver cancer before TACE,and the baseline data and prognosis of the patients,and to explore the relationship between these two blood types before TACE.Whether the biological indicators have an impact on the prognosis of patients with primary liver cancer,so that patients can benefit from it.purpose: We recorded and analyzed the LMR and ALRI values of the patients with primary liver cancer included in this study before TACE,and used the receiver operating curve(ROC curve)to determine the best cut-off values for the LMR and ALRI values;The factors influencing the prognosis of patients with hepatocellular carcinoma after TACE at 3 years were further screened out,and the factors significantly related to the prognosis were further screened out;to explore whether these two hematological indicators before TACE had an impact on the prognosis of patients with liver cancer,and if so,it could It cannot provide a new reference index for predicting the prognosis of TACE-treated patients with primary liver cancer in clinical work.Methods: In this study,we used a retrospective research method to collect a total of patients with advanced primary liver cancer who were hospitalized in the Interventional Oncology Department of Yan’an University Affiliated Hospital and received TACE from January 2014 to December 2018 120 patients,we further screened and excluded patients who were lost to follow-up according to the inclusion and exclusion criteria,and a total of 105 patients were included in this study.The connection with the follow-up patients,the death of the patient and the survival at the end of the 3-year follow-up were used as the end points of this study,and the receiver operating curve(ROC curve)was drawn to calculate and analyze the optimal cut-off value of LMR and ALRI,and passed the chi-square test.To predict the correlation between preoperative LMR and ALRI and the general clinical characteristics of patients,the Kaplan-Meier method was used to obtain the overall survival time and 3-year survival rate of liver cancer patients,and the Log-rank test was used to screen out the factors that may affect the prognosis,and then the correlation Factors were included in the multivariate COX regression analysis,and we could consider the difference to be statistically significant when p < 0.05.Results: In this study,we strictly followed the inclusion and exclusion criteria,and included a total of 105 patients with primary liver cancer who received TACE for the first time.Death and survival at the end of the 3-year follow-up were the endpoints of this study.,and then draw the receiver operating curve(ROC curve).The area under the curve of the LMR value and ALRI value is calculated and analyzed,which are 0.644 and0.763,respectively,and the corresponding optimal critical values are 3.115(sensitivity0.8,Specificity 0.529),34.15(sensitivity 0.85,specificity 0.647).Therefore,we were able to divide the study subjects into LMR<3.115 and LMR≥3.115 groups;ALRI<34.15 and ALRI≥34.15 groups according to the optimal cut-off value.According to the ROC curve to determine the survival curve analysis,the median survival time of patients with LMR≥3.115 was 21 months,the average survival time was 39.464(27.090-51.837)months,and the 3-year overall survival rate was 32.2%;The median survival time of patients with LMR<3.115 was 13 months,the mean survival time was 20.545(15.301-25.788)months,and the 3-year overall survival rate was 20.2%.The median survival time of patients with ALRI≥34.15 was 12 months,the average survival time was18.310(12.348-24.273)months,and the 3-year overall survival rate was 10.3%;the median survival time of patients with ALRI <34.15 The time was 36 months,the mean survival time was 37.816(30.626-45.007)months,and the 3-year overall survival rate was 47.7%.Univariate analysis showed that: LMR value,ALRI value,AFP value,tumor size,tumor number,portal vein tumor thrombus,AST value,hepatitis,distant metastasis and BCLC stage were all related to the survival of patients.Multivariate analysis showed that ALRI value,the number of tumors,tumor size,whether there was portal vein tumor thrombus,whether there was distant metastasis and BCLC stage were the independent influencing factors for OS after TACE(P<0.05).Conclusion:1.The 3-year survival rate of primary liver cancer patients with LMR≥3.115 was 32.2%,the 3-year survival rate of primary liver cancer patients with LMR<3.115 was 20.2%;the 3-year survival rate of primary liver cancer patients with ALRI≥34.15 was 10.3%,and the 3-year survival rate of patients with primary liver cancer with ALRI <34.15 was 47.7%.2.The ALRI value before TACE is an independent factor affecting the 3-year OS of patients with primary liver cancer after TACE.3.The ALRI value before TACE can be used as a predictor for patients with primary liver cancer,and a low level of ALRI value in patients with primary liver cancer indicates a better prognosis. |
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