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Imbalance in systemic inflammation and immune response following transarterial chemoembolization potentially increases metastatic risk in huge hepatocellular carcinoma

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Tumor Biology

Abstract

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.

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Acknowledgments

This study was supported by the State Key Project on Infectious Diseases of China (No. 2012ZX10002-016) and the Shanghai Natural Science Foundation (No. 15ZR1407100).

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    Authors and Affiliations

    1. Liver Cancer Institute, Zhongshan Hospital, Fudan University, Shanghai, China

      Tong-Chun Xue, Ning-Ling Ge, Yi Chen, Bo-Heng Zhang & Sheng-Long Ye

    2. Key Laboratory of Carcinogenesis and Cancer Invasion, Ministry of Education, Fudan University, Shanghai, China

      Tong-Chun Xue, Ning-Ling Ge, Yi Chen, Bo-Heng Zhang & Sheng-Long Ye

    3. Institutes of Biomedical Sciences, Fudan University, Shanghai, China

      Qing-An Jia

    4. Department of Medical Statistics, Zhongshan Hospital, Fudan University, Shanghai, China

      Bo-Heng Zhang

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    1. Tong-Chun Xue
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    Correspondence to Sheng-Long Ye.

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    Tong-Chun Xue and Qing-An Jia contributed equally to this work.

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    Xue, TC., Jia, QA., Ge, NL. et al. Imbalance in systemic inflammation and immune response following transarterial chemoembolization potentially increases metastatic risk in huge hepatocellular carcinoma. Tumor Biol. 36, 8797–8803 (2015). https://doi.org/10.1007/s13277-015-3632-7

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    • DOI: https://doi.org/10.1007/s13277-015-3632-7

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