Monocyte/granulocyte to lymphocyte ratio and the MELD score as predictors for early recurrence of hepatocellular carcinoma after trans-arterial chemoembolization
Background: The first-line treatment option for intermediate-stage hepatocellular carcinoma is trans-arterial chemoembolization (TACE). Blood indices, such as lymphocyte/monocyte ratio (LMR), lymphocyte count, neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR), monocyte-granulocyte/l...
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| Veröffentlicht in: | British journal of biomedical science 2018-10, Vol.75 (4), p.187-191 |
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| creator | Elalfy, H Besheer, T El-Maksoud, MA Farid, K Elegezy, M El Nakib, AM El-Aziz, MA El-Khalek, AA El-Morsy, A Elmokadem, A Elsamanoudy, AZ El-Bendary, M |
| description | Background: The first-line treatment option for intermediate-stage hepatocellular carcinoma is trans-arterial chemoembolization (TACE). Blood indices, such as lymphocyte/monocyte ratio (LMR), lymphocyte count, neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR), monocyte-granulocyte/lymphocyte ratio (MGLR) and red blood cell distribution width (RDW), are prognostic biomarkers in certain diseases. The model for end-stage liver disease (MELD) and Child-Turcotte-Pugh (CTP) scores have been designed for patients with cirrhosis waiting for liver transplantation and in patients with hepatocellular carcinoma. We hypothesized possible roles for these blood indices, and the MELD and CTP scores as predictors for early recurrence of hepatocellular carcinoma after TACE.
Methods: Routine laboratory indices determined the NLR, LMR, MGLR, RDW, PLR, as well as MELD and CTP scores in 147 patients. Sensitivity and specificity of the indices for hepatocellular carcinoma recurrence 36 months after TACE were estimated by receiver operator characteristic curve.
Results: In multivariate regression analysis, only male sex, the lymphocyte count, CTP, the MGLR and the MELD score significantly (P |
| doi_str_mv | 10.1080/09674845.2018.1494769 |
| format | Article |
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Methods: Routine laboratory indices determined the NLR, LMR, MGLR, RDW, PLR, as well as MELD and CTP scores in 147 patients. Sensitivity and specificity of the indices for hepatocellular carcinoma recurrence 36 months after TACE were estimated by receiver operator characteristic curve.
Results: In multivariate regression analysis, only male sex, the lymphocyte count, CTP, the MGLR and the MELD score significantly (P < 0.01) predicted recurrence. The area under curve (AUC) for detection of recurrence for MGLR at a cut-off value 2.75 was 0.63 (95% CI 0.54-0.72) with sensitivity 70.7%, specificity 59.2% and accuracy 63%. The MELD score at cut-off value 9.5 had diagnostic performance with AUC 0.71 (0.63-0.79), sensitivity 80% and specificity 55.8% and accuracy 71.3%.
Conclusions: High MGLR and MELD scores are linked to increasing frequency of hepatocellular carcinoma recurrence after TACE and could be used as novel, simple, non-invasive prognostic tests.</description><identifier>ISSN: 0967-4845</identifier><identifier>EISSN: 2474-0896</identifier><identifier>DOI: 10.1080/09674845.2018.1494769</identifier><identifier>PMID: 29991324</identifier><language>eng</language><publisher>England: Taylor & Francis</publisher><subject>Adult ; Aged ; Blood ; Blood indices ; Blood Platelets - pathology ; Carcinoma, Hepatocellular - blood ; Carcinoma, Hepatocellular - pathology ; Cell number ; Chemoembolization ; Chemoembolization, Therapeutic - adverse effects ; Cirrhosis ; Erythrocytes ; Female ; Granulocytes ; Granulocytes - pathology ; Hepatocellular carcinoma ; Humans ; Leukocytes (granulocytic) ; Liver cancer ; Liver cirrhosis ; Liver diseases ; Liver Neoplasms - blood ; Liver Neoplasms - pathology ; Liver transplantation ; Lymphocyte Count ; Lymphocytes ; Lymphocytes - pathology ; Male ; Medical prognosis ; MELD score ; Middle Aged ; Monocytes ; Monocytes - pathology ; Neoplasm Recurrence, Local - blood ; Neoplasm Recurrence, Local - pathology ; Neutrophils - pathology ; Patients ; Prognosis ; trans-arterial chemoembolization</subject><ispartof>British journal of biomedical science, 2018-10, Vol.75 (4), p.187-191</ispartof><rights>2018 British Journal of Biomedical Science 2018</rights><rights>2018 British Journal of Biomedical Science</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c394t-bb514338c71313d799263d897df28bcadb714cc08205c0c0dea5fb81ea48cf2c3</citedby><cites>FETCH-LOGICAL-c394t-bb514338c71313d799263d897df28bcadb714cc08205c0c0dea5fb81ea48cf2c3</cites><orcidid>0000-0002-5602-0989 ; 0000-0001-5119-9548 ; 0000-0002-0008-7455 ; 0000-0002-3751-5927 ; 0000-0002-0583-8860</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27901,27902</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/29991324$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Elalfy, H</creatorcontrib><creatorcontrib>Besheer, T</creatorcontrib><creatorcontrib>El-Maksoud, MA</creatorcontrib><creatorcontrib>Farid, K</creatorcontrib><creatorcontrib>Elegezy, M</creatorcontrib><creatorcontrib>El Nakib, AM</creatorcontrib><creatorcontrib>El-Aziz, MA</creatorcontrib><creatorcontrib>El-Khalek, AA</creatorcontrib><creatorcontrib>El-Morsy, A</creatorcontrib><creatorcontrib>Elmokadem, A</creatorcontrib><creatorcontrib>Elsamanoudy, AZ</creatorcontrib><creatorcontrib>El-Bendary, M</creatorcontrib><title>Monocyte/granulocyte to lymphocyte ratio and the MELD score as predictors for early recurrence of hepatocellular carcinoma after trans-arterial chemoembolization</title><title>British journal of biomedical science</title><addtitle>Br J Biomed Sci</addtitle><description>Background: The first-line treatment option for intermediate-stage hepatocellular carcinoma is trans-arterial chemoembolization (TACE). Blood indices, such as lymphocyte/monocyte ratio (LMR), lymphocyte count, neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR), monocyte-granulocyte/lymphocyte ratio (MGLR) and red blood cell distribution width (RDW), are prognostic biomarkers in certain diseases. The model for end-stage liver disease (MELD) and Child-Turcotte-Pugh (CTP) scores have been designed for patients with cirrhosis waiting for liver transplantation and in patients with hepatocellular carcinoma. We hypothesized possible roles for these blood indices, and the MELD and CTP scores as predictors for early recurrence of hepatocellular carcinoma after TACE.
Methods: Routine laboratory indices determined the NLR, LMR, MGLR, RDW, PLR, as well as MELD and CTP scores in 147 patients. Sensitivity and specificity of the indices for hepatocellular carcinoma recurrence 36 months after TACE were estimated by receiver operator characteristic curve.
Results: In multivariate regression analysis, only male sex, the lymphocyte count, CTP, the MGLR and the MELD score significantly (P < 0.01) predicted recurrence. The area under curve (AUC) for detection of recurrence for MGLR at a cut-off value 2.75 was 0.63 (95% CI 0.54-0.72) with sensitivity 70.7%, specificity 59.2% and accuracy 63%. The MELD score at cut-off value 9.5 had diagnostic performance with AUC 0.71 (0.63-0.79), sensitivity 80% and specificity 55.8% and accuracy 71.3%.
Conclusions: High MGLR and MELD scores are linked to increasing frequency of hepatocellular carcinoma recurrence after TACE and could be used as novel, simple, non-invasive prognostic tests.</description><subject>Adult</subject><subject>Aged</subject><subject>Blood</subject><subject>Blood indices</subject><subject>Blood Platelets - pathology</subject><subject>Carcinoma, Hepatocellular - blood</subject><subject>Carcinoma, Hepatocellular - pathology</subject><subject>Cell number</subject><subject>Chemoembolization</subject><subject>Chemoembolization, Therapeutic - adverse effects</subject><subject>Cirrhosis</subject><subject>Erythrocytes</subject><subject>Female</subject><subject>Granulocytes</subject><subject>Granulocytes - pathology</subject><subject>Hepatocellular carcinoma</subject><subject>Humans</subject><subject>Leukocytes (granulocytic)</subject><subject>Liver cancer</subject><subject>Liver cirrhosis</subject><subject>Liver diseases</subject><subject>Liver Neoplasms - blood</subject><subject>Liver Neoplasms - pathology</subject><subject>Liver transplantation</subject><subject>Lymphocyte Count</subject><subject>Lymphocytes</subject><subject>Lymphocytes - pathology</subject><subject>Male</subject><subject>Medical prognosis</subject><subject>MELD score</subject><subject>Middle Aged</subject><subject>Monocytes</subject><subject>Monocytes - pathology</subject><subject>Neoplasm Recurrence, Local - blood</subject><subject>Neoplasm Recurrence, Local - pathology</subject><subject>Neutrophils - pathology</subject><subject>Patients</subject><subject>Prognosis</subject><subject>trans-arterial chemoembolization</subject><issn>0967-4845</issn><issn>2474-0896</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kU1v1DAQhi0EokvhJ4AsceGSrb8S2zdQKR_SVlzgbDmOw6Zy4jB2VIV_wz_FYbccOHDyWHpm3tE8CL2kZE-JIldEN1IoUe8ZoWpPhRay0Y_QjgkpKqJ08xjtNqbaoAv0LKU7QqhmsnmKLpjWmnImdujXbZyiW7O_-g52WsKfGueIwzrOx9MPbB4itlOH89Hj25vDe5xcBI9twjP4bnA5QsJ9BOwthBWDdwuAn5zHscdHP9scnQ9hCRaws-CGKY4W2z57wLnkpspCqQcbsDv6MfqxjWH4ueVOz9GT3obkX5zfS_Ttw83X60_V4cvHz9fvDpXjWuSqbWsqOFdOUk55J7VmDe-Ull3PVOts10oqnCOKkdoRRzpv675V1FuhXM8cv0RvTnNniD8Wn7IZh7RtbScfl2QYaRQXtdR1QV__g97FBaaynWFUC8Jl0VGo-kQ5iCmB780Mw2hhNZSYzaF5cGg2h-bssPS9Ok9f2tF3f7sepBXg7QkYpnLz0d5HCJ3Jdg0R-nJNNyTD_5_xG50Ir2c</recordid><startdate>20181002</startdate><enddate>20181002</enddate><creator>Elalfy, H</creator><creator>Besheer, T</creator><creator>El-Maksoud, MA</creator><creator>Farid, K</creator><creator>Elegezy, M</creator><creator>El Nakib, AM</creator><creator>El-Aziz, MA</creator><creator>El-Khalek, AA</creator><creator>El-Morsy, A</creator><creator>Elmokadem, A</creator><creator>Elsamanoudy, AZ</creator><creator>El-Bendary, M</creator><general>Taylor & Francis</general><general>Taylor & Francis Ltd</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>4T-</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-5602-0989</orcidid><orcidid>https://orcid.org/0000-0001-5119-9548</orcidid><orcidid>https://orcid.org/0000-0002-0008-7455</orcidid><orcidid>https://orcid.org/0000-0002-3751-5927</orcidid><orcidid>https://orcid.org/0000-0002-0583-8860</orcidid></search><sort><creationdate>20181002</creationdate><title>Monocyte/granulocyte to lymphocyte ratio and the MELD score as predictors for early recurrence of hepatocellular carcinoma after trans-arterial chemoembolization</title><author>Elalfy, H ; Besheer, T ; El-Maksoud, MA ; Farid, K ; Elegezy, M ; El Nakib, AM ; El-Aziz, MA ; El-Khalek, AA ; El-Morsy, A ; Elmokadem, A ; Elsamanoudy, AZ ; El-Bendary, M</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c394t-bb514338c71313d799263d897df28bcadb714cc08205c0c0dea5fb81ea48cf2c3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Blood</topic><topic>Blood indices</topic><topic>Blood Platelets - pathology</topic><topic>Carcinoma, Hepatocellular - blood</topic><topic>Carcinoma, Hepatocellular - pathology</topic><topic>Cell number</topic><topic>Chemoembolization</topic><topic>Chemoembolization, Therapeutic - adverse effects</topic><topic>Cirrhosis</topic><topic>Erythrocytes</topic><topic>Female</topic><topic>Granulocytes</topic><topic>Granulocytes - pathology</topic><topic>Hepatocellular carcinoma</topic><topic>Humans</topic><topic>Leukocytes (granulocytic)</topic><topic>Liver cancer</topic><topic>Liver cirrhosis</topic><topic>Liver diseases</topic><topic>Liver Neoplasms - blood</topic><topic>Liver Neoplasms - pathology</topic><topic>Liver transplantation</topic><topic>Lymphocyte Count</topic><topic>Lymphocytes</topic><topic>Lymphocytes - pathology</topic><topic>Male</topic><topic>Medical prognosis</topic><topic>MELD score</topic><topic>Middle Aged</topic><topic>Monocytes</topic><topic>Monocytes - pathology</topic><topic>Neoplasm Recurrence, Local - blood</topic><topic>Neoplasm Recurrence, Local - pathology</topic><topic>Neutrophils - pathology</topic><topic>Patients</topic><topic>Prognosis</topic><topic>trans-arterial chemoembolization</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Elalfy, H</creatorcontrib><creatorcontrib>Besheer, T</creatorcontrib><creatorcontrib>El-Maksoud, MA</creatorcontrib><creatorcontrib>Farid, K</creatorcontrib><creatorcontrib>Elegezy, M</creatorcontrib><creatorcontrib>El Nakib, AM</creatorcontrib><creatorcontrib>El-Aziz, MA</creatorcontrib><creatorcontrib>El-Khalek, AA</creatorcontrib><creatorcontrib>El-Morsy, A</creatorcontrib><creatorcontrib>Elmokadem, A</creatorcontrib><creatorcontrib>Elsamanoudy, AZ</creatorcontrib><creatorcontrib>El-Bendary, M</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Docstoc</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Premium</collection><collection>MEDLINE - Academic</collection><jtitle>British journal of biomedical science</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Elalfy, H</au><au>Besheer, T</au><au>El-Maksoud, MA</au><au>Farid, K</au><au>Elegezy, M</au><au>El Nakib, AM</au><au>El-Aziz, MA</au><au>El-Khalek, AA</au><au>El-Morsy, A</au><au>Elmokadem, A</au><au>Elsamanoudy, AZ</au><au>El-Bendary, M</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Monocyte/granulocyte to lymphocyte ratio and the MELD score as predictors for early recurrence of hepatocellular carcinoma after trans-arterial chemoembolization</atitle><jtitle>British journal of biomedical science</jtitle><addtitle>Br J Biomed Sci</addtitle><date>2018-10-02</date><risdate>2018</risdate><volume>75</volume><issue>4</issue><spage>187</spage><epage>191</epage><pages>187-191</pages><issn>0967-4845</issn><eissn>2474-0896</eissn><abstract>Background: The first-line treatment option for intermediate-stage hepatocellular carcinoma is trans-arterial chemoembolization (TACE). Blood indices, such as lymphocyte/monocyte ratio (LMR), lymphocyte count, neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR), monocyte-granulocyte/lymphocyte ratio (MGLR) and red blood cell distribution width (RDW), are prognostic biomarkers in certain diseases. The model for end-stage liver disease (MELD) and Child-Turcotte-Pugh (CTP) scores have been designed for patients with cirrhosis waiting for liver transplantation and in patients with hepatocellular carcinoma. We hypothesized possible roles for these blood indices, and the MELD and CTP scores as predictors for early recurrence of hepatocellular carcinoma after TACE.
Methods: Routine laboratory indices determined the NLR, LMR, MGLR, RDW, PLR, as well as MELD and CTP scores in 147 patients. Sensitivity and specificity of the indices for hepatocellular carcinoma recurrence 36 months after TACE were estimated by receiver operator characteristic curve.
Results: In multivariate regression analysis, only male sex, the lymphocyte count, CTP, the MGLR and the MELD score significantly (P < 0.01) predicted recurrence. The area under curve (AUC) for detection of recurrence for MGLR at a cut-off value 2.75 was 0.63 (95% CI 0.54-0.72) with sensitivity 70.7%, specificity 59.2% and accuracy 63%. The MELD score at cut-off value 9.5 had diagnostic performance with AUC 0.71 (0.63-0.79), sensitivity 80% and specificity 55.8% and accuracy 71.3%.
Conclusions: High MGLR and MELD scores are linked to increasing frequency of hepatocellular carcinoma recurrence after TACE and could be used as novel, simple, non-invasive prognostic tests.</abstract><cop>England</cop><pub>Taylor & Francis</pub><pmid>29991324</pmid><doi>10.1080/09674845.2018.1494769</doi><tpages>5</tpages><orcidid>https://orcid.org/0000-0002-5602-0989</orcidid><orcidid>https://orcid.org/0000-0001-5119-9548</orcidid><orcidid>https://orcid.org/0000-0002-0008-7455</orcidid><orcidid>https://orcid.org/0000-0002-3751-5927</orcidid><orcidid>https://orcid.org/0000-0002-0583-8860</orcidid></addata></record> |
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| subjects | Adult Aged Blood Blood indices Blood Platelets - pathology Carcinoma, Hepatocellular - blood Carcinoma, Hepatocellular - pathology Cell number Chemoembolization Chemoembolization, Therapeutic - adverse effects Cirrhosis Erythrocytes Female Granulocytes Granulocytes - pathology Hepatocellular carcinoma Humans Leukocytes (granulocytic) Liver cancer Liver cirrhosis Liver diseases Liver Neoplasms - blood Liver Neoplasms - pathology Liver transplantation Lymphocyte Count Lymphocytes Lymphocytes - pathology Male Medical prognosis MELD score Middle Aged Monocytes Monocytes - pathology Neoplasm Recurrence, Local - blood Neoplasm Recurrence, Local - pathology Neutrophils - pathology Patients Prognosis trans-arterial chemoembolization |
| title | Monocyte/granulocyte to lymphocyte ratio and the MELD score as predictors for early recurrence of hepatocellular carcinoma after trans-arterial chemoembolization |
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