Clinical Research Papers:

Aspartate aminotransferase-lymphocyte ratio index and systemic immune-inflammation index predict overall survival in HBV-related hepatocellular carcinoma patients after transcatheter arterial chemoembolization

Zongguo Yang _, Jianliang Zhang, Yunfei Lu, Qingnian Xu, Bozong Tang, Qiang Wang, Wensi Zhang, Shishi Chen, Lingqing Lu and Xiaorong Chen

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Oncotarget. 2015; 6:43090-43098. https://doi.org/10.18632/oncotarget.5719

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Zongguo Yang1, Jianliang Zhang1, Yunfei Lu1, Qingnian Xu1, Bozong Tang1, Qiang Wang1, Wensi Zhang1, Shishi Chen1, Lingqing Lu1, Xiaorong Chen1

1Shanghai Public Health Clinical Center, Fudan University, Shanghai 201508, China

Correspondence to:

Xiaorong Chen, e-mail: [email protected]

Zongguo Yang, e-mail: [email protected]

Keywords: lymphocyte cell, aspartate aminotransferase-lymphocyte ratio index, systemic immune-inflammation index, survival, hepatocellular carcinoma

Received: August 03, 2015     Accepted: September 16, 2015     Published: October 16, 2015


It has been suggested that lymphocytes play central roles in host antitumor immune responses and control cancer outcome. We reviewed the clinical parameters of 189 hepatocellular carcinoma (HCC) patients and investigated the prognostic significance of lymphocyte-related scores in HCC patients following transcatheter arterial chemoembolization (TACE). Survival analysis revealed that an elevated aspartate aminotransferase-lymphocyte ratio index (ALRI) > 57 and a systemic immune-inflammation index (SII) > 300 were negatively associated with overall survival in HBV-related HCC (HR = 2.181, P = 0.003 and HR = 2.453, P = 0.003; respectively). Spearman chi-square analysis showed that ALRI had a specificity of 82.4% and that SII index had a sensitivity of 71.9% for HCC overall survival. ALRI and SII had negative predictive values of 74.6% and 80%, respectively for HCC overall survival. Additionally, Barcelona Clinic Liver Cancer (BCLC) stage C patients had significantly higher ALRI and SII scores (both P < 0.0001) and poorer overall survival (HR = 3.618, P < 0.001). Additionally, HCC patients with portal vein tumor thrombosis (PVTT) had higher ALRI and SII scores (P < 0.0001 and P = 0.0059, respectively). In conclusion, as noninvasive, low cost, easily assessable and reproducible parameters, elevated ALRI and SII should be used as negative predictive factors for overall survival in HBV-related HCC in clinical practice.

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