The Prognostic Significance Of Lymphocyte To Monocyte Ratio In Hepatocellular Carcinoma Patients Treated With TACE

Objective:To analyze the predictive value of preoperative lymphocyte/monocyte ratio(LMR)for the prognosis of liver cancer patients treated with TACE,and to provide a new reference index for clinical prediction of the prognosis of liver cancer patients treated with TACE.Methods:The clinical data of patients with liver cancer who underwent transarterial arterial chemoembolization(TACE)treatment from January 2008 to December 2015 at Yanbian University Hospital were retrospectively analyzed.The follow-up period was December 31,2018.2-60 months,mean follow-up time 31 months.The ROC curve was drawn at a 5-year overall survival rate to determine the cut-off value.Patients were divided into two groups according to the LMR threshold(LMR<3.272 and LMR?3.272).Univariate and multivariate comparisons were used to analyze the overall survival of LMR after TACE treatment.The evaluation value of overall survival(OS),the median survival time was analyzed by Kaplan-Meier method,and the log-rank nonparametric test method was used to compare the survival rate curves of the two groups.Results:1.A total of 124 patients were included in the clinical study according to the standard,and 100 patients died within 5 years by the end of follow-up.Survival curve analysis showed that OS in the group with LMR>3.272(25 months)at 1,3 and 5 years after surgery was significantly higher than that in the group with LMR<3.272(14 months,P<0.05).LMR,PLT,ALT,AST,ALB,TBIL,?-GT,AFP,tumor size,tumor number and portal venous tumor thrombus were not significantly different in the two groups,and the baseline balance was compared between the two groups.2.Univariate prognostic analysis showed that age(P=0.744),gender(P=0.738),NLR(P=0.81),PLR(P=0.612),AST(P=0.893),ALB(P=0.721),tumor size(P=0.713),AFP(P=0.953)had no significant correlation with OS in HCC patients treated with TACE.However,LMR,tumor number and portal vein tumor thrombus were significantly correlated with OS in patients with liver cancer treated with TACE.LMR<3.272(median survival time was 14 months),tumor multiple(median survival time was 22 months)and portal venous tumor thrombus(median survival time was 15 months)was shorter than of patients with LMR?3.272(median survival time was 25 months),single tumor(median survival time was 27 months)and no portal vein tumor thrombus(median survival time was 24 months,all P<0.05).3.The results of multivariate prognostic analysis showed that LMR,tumor number and portal venous carcinoma thrombus were independent factors affecting OS(all P<0.05).Conclusion:1.The postoperative survival of patients with liver cancer treated with TACE is related to LMR,multiple tumors and portal vein tumor number;2.Preoperative LMR can be used as an independent predictor of liver cancer,and patients with low LMR have poor prognosis after TACE treatment.