| Objectives:The purpose of this study were to investigate the relationship between the neutrophil-lymphocyte ratio(NLR)、intratumoral neutrophils and the clinicopathologic features such as age,gender,microvascular invasion and pathologic staging of patients with hepatocellular carcinoma,and to analyze the relationship of intratumoral neutrophils and intratumoral microvessel density of patients with hepatocellular carcinoma.Methods:1.All the patient demographic and clinical data including age,gender,preoperative neutrophil counts and lymphocyte counts,alanine aminotransferase(ALT),aspartate aminotransferase(AST),HBV infection,histological grade and pTNM stage were abstracted from the clinical records.2.Paraffin-embedded surgical specimens were used for the immunohistochemical analysis for CD15 and CD31 separately.3.The analysis of specimens was performed with an Olympus BX43 Microscope.Intratumoral neutrophils were infiltrated into cancer,whereas peritumoral neutrophils were the cells that distributed along the tumor—myometrial or tumor-connective tissue junction.4.Analyze the relationship between peripheral blood neutrophil count,neutrophil-lymphocyte ratio(NLR),intratumoral neutrophils and the clinicopathologic features of patients with hepatocellular carcinoma.4.All statistical analyses were conducted using SPSS version 20.0 statistical software.Chi-square test,Student’s t test,Spearman rank correlation was employed to analyze the data.A p value less than 0.05 was considered as statistically significant.Results:1.Patient characteristicsA total of 118 patients with hepatocellular carcinoma were enrolled in the research.The median age was 57 years(range,30 to 80 years),and 81%of patients were male.The histopathological differentiations were poor in 25 cases,moderate in 82 cases,and well in 11 cases.The pathological stages were Stage Ⅰ in 46 patients,stage Ⅱ in 36 patients,stage Ⅲ in 34 patients and stage Ⅳ in 2 patients.2.Correlation of NLR and peripheral blood neutrophils with clinicopathological featuresThe critical value of peripheral blood neutrophil-lymphocyte ratio(NLR)was 2.81.Then the patients were grouped into High-NLR group(NLR>2.81)and Low-NLR group(NLR<2.81).It was concluded after statistical analyses that in High-NLR group,the proportion of patients with elevated AST,micro vascular invasion,larger tumor size and worse differentiation was higher than that of patients in Low-NLR group.The median number of peripheral blood neutrophils was 2.75.According to the neutrophils count,the patients were also grouped into High neutrophil group and low neutrophil group.The peripheral blood neutrophil count has relation with ALT,AST,GGT,cirrhosis of the liver,tumor size and microvascular invasion in patients with hepatocellular carcinoma.3.Analysis of immunohistochemical parametersThe median numbers of intratumoral and peritumoral neutrophils was 25.50 cells/HPF and 18.25/HPF,respectively.The density of intratumoral neutrophils was significantly higher than that of peritumoral areas.The median numbers of intratumoral and peritumoral MVD was 25/HPF and 22.67/HPF,respectively.The intratumoral MVD was significantly associated with that of intratumoral neutrophils.4.Correlation of intratumoral neutrophils with clinicopathological featuresIncreased intratumoral neutrophils were significantly associated with advanced pTNM stages.5.The Ki67 index was not significantly associated with intratumoral neutrophils.Conclusions:1.Elevated NLR indicates larger tumor size,worse differentiation,more possibility of mcrovascular invasion,so NLR may can become one of the independent prognostic predictor of hepatocellular carcinoma.2.Increased intratumoral neutrophils were significantly associated with advanced pTNM stages and higher density of microvesels.This indicates that tumor inflammation has impact on the tumor.To a certain degree,it partly explains the reason why intratumoral neutrophils can affect the prognosis of patients with hepatocellular carcinoma. |
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