Monocyte/granulocyte to lymphocyte ratio and the MELD score as predictors for early recurrence of hepatocellular carcinoma after trans-arterial chemoembolization. Issue 4 (2nd October 2018)

• Record Type: Journal Article
• Authors: 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
• Is Part Of: British journal of biomedical science. Volume 75:Issue 4(2018)
• Page Start: 187
• Page End: 191
• Publication Date: 2018-10-02
• Subjects: Blood indices -- MELD score -- prognosis -- hepatocellular carcinoma -- trans-arterial chemoembolization; Medical sciences -- Periodicals; Medical technology -- Periodicals; Biological Science Disciplines; Clinical Laboratory Techniques; Medical Laboratory Science; Anatomie pathologique; Medical sciences; Medical technology; Klinische chemie; Laboratoriumonderzoek; Periodicals; Periodicals; 616.0756; 610.07 M489L
• DOI: 10.1080/09674845.2018.1494769
• Languages: English
• ISSNs: 0967-4845

Abstract

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.