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Platelet-to-lymphocyte ratio acts as a prognostic factor for patients with advanced hepatocellular carcinoma

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Tumor Biology

Abstract

The platelet count, as an inflammation marker, is involved in the progress of tumor invasion. However, the prognostic value of platelet counts and the platelet-to-lymphocyte ratio (PLR) has not been investigated in patients with advanced hepatocellular carcinoma (HCC). This study aimed to determine the prognostic value of platelet counts and PLR in HCC patients. A total of 243 ethnic Chinese advanced HCC patients from two major hospitals, not receiving systemic sorafenib, were analyzed retrospectively. The prognostic value of differential blood cell counts and PLR for overall survival (OS) was determined by integrating the Cancer of the Liver Italian Program (CLIP) score system and model for end-stage liver disease by using a stepwise model of multivariate Cox regression. The Kaplan–Meier method and receiver operating characteristic (ROC) curves were utilized accordingly. PLR was confirmed to be an independent predictor for OS (p < 0.01), while the remaining parameters had no predictive value. Then, advanced HCC patients were dichotomized into two groups based on the PLR value (≤111.23 or >111.23), according to ROC analysis. Patients with a high PLR had a lower 3-month survival rate (37.6 vs. 57.6 %) compared with patients with a low PLR. PLR was associated with aggressive malignant behavior, characterized by distant metastasis and portal vein thrombosis. Additionally, PLR was not associated with the CLIP score and Child–Pugh grade. PLR was identified as an independent prognostic factor for advanced HCC patients not receiving systemic sorafenib; the predictive ability of PLR partially relies on its association with the aggressive nature of HCC.

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Conflicts of interest

None

Financial support

This work was supported by grants from the National Natural Science Foundation of China (No. 81372374), the Combination Project of Production, Education and Research from Guangdong Province and Ministry of Education (No. 2012B091100460), and the Science and Technology Planning Project of Guangdong Province 2011B031800076 (to Q. Lin), 2011B031800014 (to M. Dong) and 2012B031800259 (to J. Wen).

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Authors and Affiliations

  1. Department of Medical Oncology, The Third Affiliated Hospital of Sun Yat-sen University, 600 Tianhe Road, Guangzhou, 510630, China

    Xing Li, Zhan-Hong Chen, Tian-Tian Wang, Dong-Hao Wu, Jing-Yun Wen, Jie Chen, Qu Lin, Min Dong, Li Wei, Dan-Yun Ruan, Ze-Xiao Lin, Xiang-Yuan Wu & Xiao-Kun Ma

  2. Department of Nephrology, The Third Affiliated Hospital of Guangzhou Medical University, 63 Duobao Road, Guangzhou, 510150, China

    Yan-Fang Xing

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  1. Xing Li
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  2. Zhan-Hong Chen
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  3. Yan-Fang Xing
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  4. Tian-Tian Wang
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  5. Dong-Hao Wu
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  7. Jie Chen
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  8. Qu Lin
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  9. Min Dong
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  10. Li Wei
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  12. Ze-Xiao Lin
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  13. Xiang-Yuan Wu
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  14. Xiao-Kun Ma
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Correspondence to Xiang-Yuan Wu or Xiao-Kun Ma.

Additional information

Xing Li, Zhan-Hong Chen, and Yan-Fang Xing contributed equally to this work.

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Li, X., Chen, ZH., Xing, YF. et al. Platelet-to-lymphocyte ratio acts as a prognostic factor for patients with advanced hepatocellular carcinoma. Tumor Biol. 36, 2263–2269 (2015). https://doi.org/10.1007/s13277-014-2833-9

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  • DOI: https://doi.org/10.1007/s13277-014-2833-9

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