The Clinical Significance Of NLR And ANRI In Predicting The Prognosis Of Hepatocellular Carcinoma After TACE Treatment

Objective:To investigate the clinical significance of the ratio of peripheral bio od neutrophils to lymphocytes(NLR)and the ratio of glutamate transaminase to neutrophils(ANRI)in predicting the prognosis of patients with hepatocellular c arcinoma(HCC)treated with transcatheter chemoembolization(TACE).Methods:From January 2009 to December 2014,116 cases of HCC patients r eceiving TACE treatment in the Oncology Department of Yanbian Hospital were selected.General information of patients,laboratory examination and imaging e xamination were collected according to the electronic medical record system,an d preoperative NLR and preoperative ANRI were calculated.Patients were folio wed up after receiving TACE treatment for the first time,and the deadline of f ollow-up was December 31,2018.Subject operating curves(ROC curves)of pr eoperative NLR and preoperative ANRI were drawn according to patients’ 5-yea r total survival period(OS)?and their truncation values were calculated respecti vely.The cut-off values were divided into high NLR group,low NLR group,h igh ANRI group and low ANRI group.Compare the area of NLR and ANRI u nder the ROC curve.Kaplan-meier survival analysis was used to analyze the ge neral data,preoperative NLR and preoperative ANRI.The factors with statistical signifieanee in the log-rank univariate analysis results were incorporated into th e COX risk ratio model for multivariate analysis,and independent risk factors a ffecting the Prognosis of Patients after TACE treatment were screened out.Results:l.The optimal truncation values of NLR and ANRI were 1.32 and 15.6,respecti vely,and the area under the ROC curve(AUC)was 0.629 and 0.626,respectiv ely.The 1-year,3-year and 5-year survival rates in the low and high NLR gro ups were 94.12%,58.82%,50%,73.17%,35.37%and 25.61%,respectively.The 1-year,3-year and 5-year survival rates of the low ANRI group and the high ANRI group were 80.95%,50%,47.62%,78.38%,37.84%and 24.32%,respecti vely.2.Univariate analysis showed that the history of chronic hepatitis b(P=0.022),A NRI(P=0.037)and NLR(P=0.007)were all prognostic factors of HCC patients treated with TACE(P<0.05).All the other factors were not statistically signific ant.Patients with a history of hepatitis b in the median survival time was 45 months,patients with a history of hepatitis c in the median survival time was 25 months,low NLR group of 56 months and the median survival time for high NLR group median survival time was 24 months,low ANRI groups of the me dian survival time for 36 months,high ANRI group median survival time was 27 months.3.Multivariate analysis showed that NLR(P=0.002)and ANRI(P=0.021)were i ndependent risk factors for the prognosis of HCC patients treated with TACE(P<0.05).High preoperative NLR and high preoperative ANRI are risk factors f or prognosis after TACE treatment.Conclusion:1.The prognosis of HCC patients with preoperative NLR higher than 1.32 after TACE treatment was poor.2.The prognosis of HCC patients with preoperative ANRI higher than 15.6 after TACE treatment was poor.