关键词：
hepatocellular carcinoma
extrahepatic metastasis
systemic inflammatory response
摘要：
Several indices have been proposed to evaluate the systemic inflammatory response (SIR), which has been reported to be a useful prognostic factor in various types of cancer. We investigated the usefulness of the Glasgow Prognostic Score (GPS), neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) as prognostic factors in patients with advanced hepatocellular carcinoma (HCC) with extrahepatic metastasis (stage IVB). Between April, 1997 and March, 2013, a total of 434 HCC patients who developed extrahepatic metastasis were enrolled in the present study. The GPS was defined on the basis of pretreatment C-reactive protein (CRP) and albumin (Alb) levels, and the subjects were grouped according to GPS 0-2. The NLR was calculated as the neutrophil *** count, and the PLR was calculated as the platelet *** count. A comparative examination was performed using a survival analysis with approximate median values to determine the cut-off value for both ratios. The median survival time (MST) of the 434 patients overall was 7.3 months, with cumulative survival rates of 31.8, 14.5 and 7.7% at 1, 2 and 3 years, respectively. The patient backround was as follows: The male: female ratio was 363: 71, with a median age of 67.0 years (range, 15.0-92.0 years). Hepatitis B virus patients: hepatitis C virus patients: non-B, non-C hepatitis patients = 75:303:56. Child-Pugh class A:B:C = 218:153:63. As regards T stage, <= T2:T3:T4 = 60: 190: 181. The median white blood cell count was 4,650/l (range, 1,400-20,500/l);the platelet count was 11.1x10(4)/mu l (range, 3.1x10(4)-45.5x10(4)/mu l);the aspartate aminotransferase level was 40.0 U/l (range, 7.0-338.0 U/l) and the alanine aminotransferase level 64.5 U/l (range, 16.0-407.0 U/l);the a-fetoprotein level was 622.1 ng/ml (range, 1.5-3,311,794.0 ng/ml);and the des-gamma-carboxyprothrombin level was 1,285.0 mAU/ml (range, 8.0->75,000 mAU/ml). The principal sites of metastasis included the lungs (53.9
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中文科技期刊
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