Abstract
BackgroundThe neutrophil–lymphocyte ratio (NLR) is a new prognostic predictor for patients with liver cancer. The association of NLR and T lymphocytes with the pathogenesis and progression of liver cancer is poorly understood.MethodsSeventy-three patients with hepatitis B virus (HBV)-associated primary liver cancer (HBV-PLC), 50 patients with HBV-associated liver cirrhosis (HBV-LC) and 37 patients with chronic HBV infection (CHB) were prospectively enrolled from July 1, 2013 to February 28, 2014 in Beijing Ditan Hospital, Capital Medical University (Beijing, China). The NLR, proportions and concentrations of neutrophils and lymphocytes, concentration of subpopulations of lymphocytes, and the expression of CD31 (index for recent thymic output) and HLA-DR (index for activation of T lymphocytes) of T cells in the peripheral blood samples of the patients were assessed and statistically compared between different groups.ResultsThe NLR was significantly increased from patients with CHB, those with HBV-LC to those with HBV-PLC (P<0.05), along with significant increase of neutrophils and decrease of lymphocytes in the same way (P<0.05). The concentrations of T lymphocytes, natural killer cells, B cells, CD4+ T cells and CD8+ T cells were decreased from patients with CHB, those with HBV-LC to those with HBV-PLC, and were significantly reduced in patients with HBV-PLC compared with those in patients with CHB (P<0.05). The CD31 and HLA-DR expression of naive CD4+ and CD8+ T cells was significantly decreased and increased, respectively in patients with HBV-PLC compared with that in patients with CHB.ConclusionsElevated NLR, resulted from the increase of neutrophils and decrease of lymphocytes, is positively associated with the pathogenesis and progression of HBV-PLC. The reduced thymic output and hyperactivation of T lymphocytes may contribute to the decrease of T lymphocytes, which could be also related to the pathogenesis of HBV-PLC.
Highlights
Primary liver cancer (PLC) mainly consisting of hepatocellular carcinoma (HCC) is the fifth most common cancer worldwide [1] and the second most common cause of cancer mortality in men and the sixth in women [2]
The concentrations of T lymphocytes, natural killer cells, B cells, CD4+ T cells and CD8+ T cells were decreased from patients with chronic HBV infection (CHB), those with hepatitis B virus (HBV)-liver cirrhosis (LC) to those with HBV-associated PLC (HBV-PLC), and were significantly reduced in patients with HBVPLC compared with those in patients with CHB (P
The reduced thymic output and hyperactivation of T lymphocytes may contribute to the decrease of T lymphocytes, which could be related to the pathogenesis of HBV-PLC
Summary
Primary liver cancer (PLC) mainly consisting of hepatocellular carcinoma (HCC) is the fifth most common cancer worldwide [1] and the second most common cause of cancer mortality in men and the sixth in women [2]. Preoperative and postoperative NLR had been used as a poor prognostic factor for the treatment of various types of cancer such as liver cancer [5,6,7,8,9,10]. A recent study showed that the significant association of preoperative NLR with poor prognosis of HCC patients was only applied to TNM stage I instead of stage II or III HCC [9]. The dynamic changes of NLR during the pathogenesis and progression of liver cancer have not yet been fully elucidated. The neutrophil–lymphocyte ratio (NLR) is a new prognostic predictor for patients with liver cancer. The association of NLR and T lymphocytes with the pathogenesis and progression of liver cancer is poorly understood
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