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Neutrophil-To-Lymphocyte Ratio As an Index of Treatment Response to Trans-Arterial Chemoembolization in Hepatocellular Carcinoma Publisher



Shayegan N1 ; Ayoobi N2 ; Mohammadi E2 ; Saberi H3 ; Salahshour F2, 3, 4 ; Alborzi F1 ; Ziamanesh F1 ; Sadighi N2 ; Taher M1, 4
Authors
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Authors Affiliations
  1. 1. Division of Gastroenterology & Hepatology, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran
  2. 2. Department of Radiology, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran
  3. 3. Advanced Diagnostic and Interventional Radiology Research Center (ADIR), Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran
  4. 4. Liver Transplantation Research Center, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran

Source: Gastroenterology and Hepatology from Bed to Bench Published:2024


Abstract

Aim: We evaluated the response to Trans-arterial chemoembolization (TACE) in hepatocellular carcinoma (HCC) patients according to modified Response Evaluation Criteria in Solid Tumors (mRECIST) criteria. We determined the prognostic value of the neutrophil-to-lymphocyte ratio (NLR). Background: TACE is the most commonly used method to treat patients with large, unresectable tumors or as bridge therapy in patients with HCC before liver transplantation. Methods: In this cross-sectional study, patients with a diagnosis of HCC who were referred for TACE were studied. The response rate to TACE treatment was assessed based on dynamic MRI 28 days after treatment according to mRECIST criteria. The NLR value was calculated, and its prognostic value was evaluated to predict the response to treatment. Results: Forty patients with HCC who underwent TACE were included. The response to TACE treatment included a complete response (CR) in 6 patients (15%), partial response (PR) in 16 patients (40%), and stable disease (SD) in 18 patients (45%). No progressive disease (PD) was found. Responders (CR and PR) were 22 patients (55%). The mean NLR after treatment in the non-responders was significantly higher than in the responders (4.2 vs. 2.4, P-value = 0.026). NLR values greater than 2.6 after treatment had a sensitivity of 70.6% and a specificity of 77.3% in diagnosing non-responders, with an Area Under the Curve (AUC) of 0.73 [95% confidence interval 0.58-0.89], P-value = 0.011. Conclusion: Non-responders observed higher levels of NLR after treatment than responders. As a moderate prognostic factor, an NLR level of more than 2.6 after treatment could discriminate against non-responders. © 2024, Gastroenterology and Hepatology From Bed to Bench (GHFBB).
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