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  11. Prognostic Value Of Circulating Tumor Cells Combined With Neutrophil-lymphocyte Ratio In Patients With Hepatocellular Carcinoma

Prognostic value of circulating tumor cells combined with neutrophil-lymphocyte ratio in patients with hepatocellular carcinoma

Jia-Li Chen1, Lu Guo2, Zhen-Ying Wu1

  • 1Department of Oncology, The Affiliated Hospital of Southwest Medical University, Luzhou 646000, Sichuan Province, China.

World Journal of Gastrointestinal Oncology
|March 1, 2024

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View abstract on PubMed

Summary
This summary is machine-generated.

Combining circulating tumor cell (CTC) counts and neutrophil-to-lymphocyte ratio (NLR) can predict prognosis in advanced hepatocellular carcinoma (HCC). A high CTC-NLR score indicates a poorer survival outcome for patients undergoing immunotherapy and targeted therapy.

Area of Science:

  • Oncology
  • Immunotherapy
  • Hepatocellular Carcinoma Research

Background:

  • Circulating tumor cell (CTC) count and neutrophil-to-lymphocyte ratio (NLR) are established prognostic markers for hepatocellular carcinoma (HCC).
  • Assessing the combined prognostic value of CTCs and NLR in advanced HCC is crucial for treatment stratification.

Purpose of the Study:

  • To evaluate the prognostic significance of combining CTC programmed death-ligand 1 (PD-L1) expression and NLR in advanced HCC patients.
  • To determine if the combined CTC-NLR score improves prognostic prediction compared to individual markers.

Main Methods:

  • Retrospective analysis of clinical data from advanced HCC patients treated with immunotherapy and targeted therapy (2021-2023).
  • Optimal cutoff values for CTC PD-L1 and NLR were determined using X-Tile software.
Keywords:
Circulating tumor cellsHepatocellular carcinomaMarkerNeutrophil–lymphocyte ratio

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  • Patients were grouped into CTC-NLR (0), (1), and (2) based on combined marker levels; survival analysis was performed.

    • Main Results:

    • High baseline CTC PD-L1 expression or NLR correlated with significantly shorter progression-free survival (PFS) and overall survival (OS) (P < 0.001).
    • Patients in the high CTC-NLR (2) group exhibited markedly reduced mPFS and mOS.
    • CTC-NLR, along with alpha-fetoprotein (AFP) and CTC PD-L1, independently predicted OS; CTC-NLR showed superior predictive accuracy at 12 and 18 months.

    Conclusions:

    • Elevated CTC PD-L1 expression or NLR in HCC patients is associated with poor prognosis.
    • The combined CTC-NLR score serves as an effective prognostic indicator for advanced HCC patients receiving combined immunotherapy and targeted therapy.
    • High CTC-NLR scores may signify a worse survival outcome, aiding in clinical decision-making.
    Prognosis
    Survival