Imbalance in systemic inflammation and immune response following transarterial chemoembolization potentially increases metastatic risk in huge hepatocellular carcinoma.
Inflammation plays a critical role in tumor metastasis. However, few inflammation-related biomarkers are currently available to predict the risk of metastasis for advanced hepatocellular carcinoma (HCC). Using huge tumors (diameter >10 cm) as a model, we evaluated the potential risk of pre- and post-treatment inflammatory responses in the development of metastasis of HCC patients undergoing transarterial chemoembolization (TACE). A logistic regression model was used to analyze the risk factors. One hundred and sixty-five patients with huge HCC were enrolled in the study. Metastases were identified in 25.5% (42/165) patients by imaging evaluation post-TACE. Neutrophils increased, whereas lymphocytes decreased significantly post-TACE. Univariate analysis showed that high post-treatment neutrophil-to-lymphocyte ratio (NLR; p = 0.003), low post-treatment lymphocyte count (p = 0.047), and high baseline NLR (p = 0.100) were potential risk factors for metastasis. Further, multivariate analysis showed that high post-treatment NLR, but not pre-treatment NLR, was an independent risk factor for metastasis; this was confirmed by receiver operating characteristic curve analysis. Post-treatment NLR, however, had no correlation to tumor response and overall survival of patients. In conclusion, post-treatment NLR but not pre-treatment NLR independently increases the risk of metastasis in huge HCC. Our findings suggest the potential contribution of treatment-related inflammation to metastasis in advanced HCC.
['Xue|Tong-Chun|TC|', 'Jia|Qing-An|QA|', 'Ge|Ning-Ling|NL|', 'Chen|Yi|Y|', 'Zhang|Bo-Heng|BH|', 'Ye|Sheng-Long|SL|']
D000328:Adult D000368:Aged D006528:Carcinoma, Hepatocellular D016461:Chemoembolization, Therapeutic D005260:Female D006801:Humans D007113:Immunity, Innate D007249:Inflammation D053208:Kaplan-Meier Estimate D008113:Liver Neoplasms D018655:Lymphocyte Count D008297:Male D008875:Middle Aged D009362:Neoplasm Metastasis D009504:Neutrophils D012307:Risk Factors
Inflammation Immune Chemoembolization Hepatocellular carcinoma Metastasis