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High lymphocyte?to?monocyte ratio is associated with low ??fetoprotein expression in patients with hepatitis B virus?associated hepatocellular carcinoma.

ABSTRACT: The association of the peripheral lymphocyte?to?monocyte ratio (LMR) with ??fetoprotein (AFP) status in patients with AFP?positive and AFP?negative hepatocellular carcinoma (HCC) has not been investigated in detail. The aim of the present study was to examine the association between the LMR and AFP status in these patients. The samples were obtained from patients with a hepatitis B virus (HBV) infection, who were negative for non?HBV hepatitis viruses and who did not suffer from autoimmune hepatitis. These patients were retrospectively reviewed and the differences of test indicators in the AFP?negative and AFP?positive groups were assessed. Flow cytometry was used to detect the expression levels of CD4, CD8 and programmed cell death protein 1 (PD?1), and ELISAs were used to analyze the expression levels of interleukin (IL)?10 and transforming growth factor (TGF)??1. In addition, luciferase reporter assays were used to assess binding of the IL?10 promoter to the glucocorticoid receptor (GR) gene. Receiver operating characteristic curve and Spearman correlation analyses demonstrated that the AFP?negative HCC group exhibited a higher LMR, lower D?dimer and lower fibrin degradation products compared with the AFP?positive HCC group. The cut?off value of the LMR was 2.01 for AFP detection, with a sensitivity of 68.6% and a specificity of 75%. The high LMR noted in the AFP?negative HCC group was accompanied by a lower proportion of CD4+ T lymphocytes and CD8?PD?1 expression compared with the corresponding levels of these parameters in the AFP?positive HCC group. Furthermore, the high levels of IL?10 and low levels of TGF??1 were expressed in the AFP?positive HCC group. The data indicated that the IL?10?592 promoter exhibited a potent induction of luciferase activity in 293T cells cotransfected with a GR?overexpressing vector compared with the control cells. However, the relative luciferase activity was not altered following a mutation or polymorphism in the IL?10 gene. These results suggested that a high LMR was indicative of low AFP expression in HBV?associated HCC patients.

SUBMITTER: Wang H

PROVIDER: S-EPMC7453599 | biostudies-literature | 2020 Jul

REPOSITORIES: biostudies-literature

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High lymphocyte‑to‑monocyte ratio is associated with low α‑fetoprotein expression in patients with hepatitis B virus‑associated hepatocellular carcinoma.

Wang Haixia H Xiang Yu Y Li Xinyu X Liu Shuang S Liu Linxiu L

Molecular medicine reports 20200729 4

The association of the peripheral lymphocyte‑to‑monocyte ratio (LMR) with α‑fetoprotein (AFP) status in patients with AFP‑positive and AFP‑negative hepatocellular carcinoma (HCC) has not been investigated in detail. The aim of the present study was to examine the association between the LMR and AFP status in these patients. The samples were obtained from patients with a hepatitis B virus (HBV) infection, who were negative for non‑HBV hepatitis viruses and who did not suffer from autoimmune hepat ...[more]

PMID: 32945410

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Project description:BackgroundThis study aimed to investigate the role of the alpha fetoprotein (AFP) ratio before and after curative resection in the prognosis of patients with hepatocellular carcinoma (HCC) and to develop a novel pre- to postoperative AFP ratio nomogram to predict recurrence free survival (RFS) for HCC patients after curative resection.MethodsA total of 485 pathologically confirmed HCC patients who underwent radical hepatectomy from January 2010 to December 2018 were retrospectively analyzed. The independent prognostic factors of hepatocellular carcinoma were identified by multivariate COX proportional model analysis, and the nomogram model was constructed. The receiver operating characteristic and the C-index were used to evaluate the accuracy and efficacy of the model prediction, the correction curve was used to assess the calibration of the prediction model, and decision curve analysis was used to evaluate the clinical application value of the nomogram model.ResultsA total of 485 HCC patients were divided into the training cohort (n = 340) and the validation cohort (n = 145) by random sampling at a ratio of 7:3. Using X-tile software, it was found that the optimal cut-off value of the AFP ratio in the training cohort was 0.8. In both cohorts, the relapse-free survival of patients with an AFP ratio <0.8 (high-risk group) was significantly shorter than in those with an AFP ratio ≥0.8 (low-risk group) (P < 0.05). An AFP ratio <0.8 was an independent risk factor for recurrence of HCC after curative resection. Based on the AFP ratio, BCLC stage and cirrhosis diagnosis, a satisfactory nomogram was developed. The AUC of our nomogram for predicting 1-, 3-, and 5-year RFS was 0.719, 0.690, and 0.708 in the training cohort and 0.721, 0.682, and 0.681 in the validation cohort, respectively. Furthermore, our model demonstrated excellent stratification as well as clinical applicability.ConclusionThe AFP ratio was a reliable biomarker for tumor recurrence. This easy-to-use AFP ratio-based nomogram precisely predicted tumor recurrence in HCC patients after curative resection.

Dataset Information

High lymphocyte?to?monocyte ratio is associated with low ??fetoprotein expression in patients with hepatitis B virus?associated hepatocellular carcinoma.

Publications

High lymphocyte‑to‑monocyte ratio is associated with low α‑fetoprotein expression in patients with hepatitis B virus‑associated hepatocellular carcinoma.

Similar Datasets

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