Prognostic significance of inflammatory indices in hepatocellular carcinoma treated with transarterial chemoembolization: A systematic review and meta-analysis

Shuangshuang Li; Xudong Feng; Guodong Cao; Qianhui Wang; Ling Wang

doi:10.1371/journal.pone.0230879

Prognostic significance of inflammatory indices in hepatocellular carcinoma treated with transarterial chemoembolization: A systematic review and meta-analysis

PLoS One. 2020 Mar 26;15(3):e0230879. doi: 10.1371/journal.pone.0230879. eCollection 2020.

Authors

Shuangshuang Li¹, Xudong Feng², Guodong Cao³, Qianhui Wang⁴, Ling Wang¹

Affiliations

¹ Department of Microbiology and Center of Infectious Disease, School of Basic Medical Sciences, Peking University Health Science Center, Beijing, People's Republic of China.
² State Key Laboratory for the Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang province, People's Republic of China.
³ Department of Surgery, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, People's Republic of China.
⁴ Department of Infectious Diseases, Taiyuan No. 3 Hospital, Taiyuan, Shanxi Province, People's Republic of China.

Abstract

Objectives: To investigate the association between inflammatory indices and clinical outcomes of hepatocellular carcinoma (HCC) patients treated with transarterial chemoembolization (TACE) by performing meta-analysis.

Methods: A systematic literature search for relevant studies published up to August 2019 was performed by using PubMed, Web of Science, EMBASE, China National Knowledge Internet (CNKI) and Wanfang databases. Pooled hazard ratios (HR) or odds ratio (OR) and 95% confidence intervals (95% CI) were calculated.

Results: A total of 5280 patients from 22 studies were finally enrolled in the meta-analysis. The results demonstrated that elevated preoperative NLR, PLR, and CRP was associated with poor OS in HCC patients treated by TACE (HR = 1.81, P<0.00001; HR = 1.56, P = 0.007; HR = 1.45, P<0.00001, respectively). In addition, high NLR was significantly correlated with the presence of tumor vascular invasion (OR = 1.49, P = 0.002). Elevated PLR tended to be correlated with higher incidence of tumor size>3 cm (OR = 2.42, P = 0.005).

Conclusions: Elevated preoperative NLR, PLR, and CRP are associated with poor prognosis in HCC patients treated with TACE. These inflammatory indices may be convenient, accessible, affordable and dependable biomarkers with prognostic potential for HCC patients treated by TACE.

Publication types

Meta-Analysis
Research Support, Non-U.S. Gov't
Systematic Review

MeSH terms

Arteries*
Carcinoma, Hepatocellular / diagnosis*
Carcinoma, Hepatocellular / therapy*
Chemoembolization, Therapeutic
Humans
Liver Neoplasms / diagnosis*
Liver Neoplasms / therapy*
Prognosis

Grants and funding

This research was supported by National Natural Science Foundation of China (No.81772175). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.