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Article

Diabetes mellitus and the neutrophil to lymphocyte ratio predict overall survival in non‑viral hepatocellular carcinoma treated with transarterial chemoembolization

  • Authors:
    • Jiangguo Zhang
    • Fengyun Gong
    • Ling Li
    • Manzhi Zhao
    • Jianxin Song
  • View Affiliations / Copyright

    Affiliations: Department of Infectious Diseases, Tongji Hospital, Huazhong University of Science and Technology, Wuhan, Hubei 430030, P.R. China, Department of Infectious Diseases, The Fourth Hospital of Wuhan, Wuhan, Hubei 430030, P.R. China
  • Pages: 1704-1710
    |
    Published online on: February 20, 2014
       https://doi.org/10.3892/ol.2014.1896
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Abstract

Diabetes mellitus (DM) and systemic inflammation are closely associated with the development of hepatocellular carcinoma (HCC). However, the prognostic significance of DM on HCC remains controversial. The main purpose of the present study was to evaluate the effects of DM and the systemic inflammation‑based neutrophil to lymphocyte ratio (NLR) on the overall survival (OS) rate of non‑viral HCC patients treated with transarterial chemoembolization (TACE). A retrospective analysis of 138 patients with HCC, who were diagnosed between 2002 and 2012 with non‑viral causes and who later underwent TACE, was performed. Among these patients, 34 (24.6%) had pre‑existing DM and 46 (33.3%) exhibited an elevated baseline NLR (≥5). The multivariate analysis showed that DM, the NLR and a portal vein tumor thrombus (PVTT) were independent predictors for a poor OS rate (P<0.05). The patients with DM and an elevated NLR exhibited a poorer OS rate when compared with patients without these factors. In addition, there was a significant stepwise improvement in the OS rate of patients with DM and an elevated NLR, and in patients with only one of these factors compared with patients without either (P<0.01). Finally, DM was significantly correlated with PVTT and elevated γ‑glutamyl transpeptidase levels, while the NLR was independently associated with PVTT and tumor multiplicity (P<0.05). The present study revealed that DM, baseline NLR and PVTT are independent indicators of the OS rate in non‑viral HCC patients treated with TACE. DM and NLR may affect the OS rate by promoting the malignant progression of HCC. The combination of DM and NLR appears to be a stronger predictor for OS than DM or NLR alone.
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1 

Parkin DM, Bray F, Ferlay J and Pisani P: Global cancer statistics, 2002. CA Cancer J Clin. 55:74–108. 2005. View Article : Google Scholar

2 

Shi J, Zhu L, Liu S and Xie WF: A meta-analysis of case-control studies on the combined effect of hepatitis B and C virus infections in causing hepatocellular carcinoma in China. Brit J Cancer. 92:607–612. 2005.

3 

Chang MH, You SL, Chen CJ, et al; Taiwan Hepatoma Study Group. Decreased incidence of hepatocellular carcinoma in hepatitis B vaccinees: a 20-year follow-up study. J Natl Cancer Inst. 101:1348–1355. 2009.

4 

Papatheodoridis GV, Lampertico P, Manolakopoulos S and Lok A: Incidence of hepatocellular carcinoma in chronic hepatitis B patients receiving nucleos(t)ide therapy: a systematic review. J Hepatol. 53:348–356. 2010. View Article : Google Scholar : PubMed/NCBI

5 

Shiratori Y, Ito Y, Yokosuka O, et al; Tokyo-Chiba Hepatitis Research Group. Antiviral therapy for cirρtic hepatitis C: association with reduced hepatocellular carcinoma development and improved survival. Ann Intern Med. 142:105–114. 2005.

6 

Hatanaka K, Kudo M, Fukunaga T, et al: Clinical characteristics of NonBNonC- HCC: Comparison with HBV and HCV related HCC. Intervirology. 50:24–31. 2007. View Article : Google Scholar

7 

Llovet JM and Bruix J: Novel advancements in the management of hepatocellular carcinoma in 2008. J Hepatol. 48(Suppl 1): S20–S37. 2008. View Article : Google Scholar : PubMed/NCBI

8 

Lencioni R, Chen XP, Dagher L and Venook AP: Treatment of intermediate/advanced hepatocellular carcinoma in the clinic: how can outcomes be improved? Oncologist. 15(Suppl 4): S42–S52. 2010. View Article : Google Scholar

9 

Llovet JM and Bruix J: Systematic review of randomized trials for unresectable hepatocellular carcinoma: Chemoembolization improves survival. Hepatology. 37:429–442. 2003. View Article : Google Scholar

10 

Nagaoki Y, Hyogo H, Aikata H, et al: Recent trend of clinical features in patients with hepatocellular carcinoma. Hepatol Res. 42:368–375. 2012. View Article : Google Scholar : PubMed/NCBI

11 

Koh WP, Wang R, Jin A, Yu MC and Yuan JM: Diabetes mellitus and risk of hepatocellular carcinoma: findings from the Singapore Chinese Health Study. Brit J Cancer. 108:1182–1188. 2013. View Article : Google Scholar

12 

Djiogue S, Nwabo Kamdje AH, Vecchio L, et al: Insulin resistance and cancer: the role of insulin and IGFs. Endocr Relat Cancer. 20:R1–R17. 2013. View Article : Google Scholar : PubMed/NCBI

13 

Mehta NN, McGillicuddy FC, Anderson PD, et al: Experimental endotoxemia induces adipose inflammation and insulin resistance in humans. Diabetes. 59:172–181. 2010. View Article : Google Scholar

14 

Grivennikov SI, Greten FR and Karin M: Immunity, inflammation, and cancer. Cell. 140:883–899. 2010. View Article : Google Scholar

15 

Alison MR, Nicholson LJ and Lin WR: Chronic inflammation and hepatocellular carcinoma. Recent Results Cancer Res. 185:135–148. 2011. View Article : Google Scholar : PubMed/NCBI

16 

Ting CT, Chen RC, Chen CC, Liu MH, Chu D and Kuo NW: Diabetes worsens the surgical outcomes in cirρtic patients with hepatocellular carcinoma. Tohoku J Exp Med. 227:73–81. 2012.PubMed/NCBI

17 

Huo TI, Hsu CY, Huang YH, et al: Diabetes mellitus as an independent prognostic predictor and its association with renal dysfunction in patients with hepatocellular carcinoma. Liver Int. 30:198–207. 2010. View Article : Google Scholar

18 

Huo TI, Wu JC, Lui WY, et al: Differential mechanism and prognostic impact of diabetes mellitus on patients with hepatocellular carcinoma undergoing surgical and nonsurgical treatment. Am J Gastroenterol. 99:1479–1487. 2004. View Article : Google Scholar

19 

Limaye AR, Clark V, Soldevila-Pico C, et al: Neutrophil-lymphocyte ratio predicts overall and recurrence-free survival after liver transplantation for hepatocellular carcinoma. Hepatol Res. 43:757–764. 2012. View Article : Google Scholar

20 

Bruix J and Sherman M; Practice Guidelines Committee, American Association for the Study of Liver Diseases. Management of hepatocellular carcinoma. Hepatology. 42:1208–1236. 2005. View Article : Google Scholar

21 

Lagiou P, Kuper H, Stuver SO, Tzonou A, Trichopoulos D and Adami HO: Role of diabetes mellitus in the etiology of hepatocellular carcinoma. J Natl Cancer Inst. 92:1096–1099. 2000. View Article : Google Scholar : PubMed/NCBI

22 

Shau WY, Shao YY, Yeh YC, et al: Diabetes mellitus is associated with increased mortality in patients receiving curative therapy for hepatocellular carcinoma. Oncologist. 17:856–862. 2012. View Article : Google Scholar

23 

Kaibori M, Ishizaki M, Matsui K, Kitade H, Matsui Y and Kwon AH: Evaluation of metabolic factors on the prognosis of patients undergoing resection of hepatocellular carcinoma. J Gastroenterol Hepatol. 26:536–543. 2011. View Article : Google Scholar

24 

Kawamura Y, Ikeda K, Arase Y, et al: Diabetes mellitus worsens the recurrence rate after potentially curative therapy in patients with hepatocellular carcinoma associated with nonviral hepatitis. J Gastroenterol Hepatol. 23:1739–1746. 2008. View Article : Google Scholar

25 

Connolly GC, Safadjou S, Kashyap R, Chen R, Orloff MS and Hezel AF: Diabetes mellitus impacts risk of macrovascular invasion in patients undergoing transplantation for hepatocellular carcinoma. BMC Gastroenterol. 13:92013. View Article : Google Scholar

26 

Giannelli G, Pierri F, Trerotoli P, et al: Occurrence of portal vein tumor thrombus in hepatocellular carcinoma affects prognosis and survival: A retrospective clinical study of 150 cases. Hepatol Res. 24:502002. View Article : Google Scholar

27 

Zhao WC, Fan LF, Yang N, Zhang HB, Chen BD and Yang GS: Preoperative predictors of microvascular invasion in multinodular hepatocellular carcinoma. Eur J Surg Oncol. 39:858–864. 2013. View Article : Google Scholar : PubMed/NCBI

28 

McNally ME, Martinez A, Khabiri H, et al: Inflammatory markers are associated with outcome in patients with unresectable hepatocellular carcinoma undergoing transarterial chemoembolization. Ann Surg Oncol. 20:923–928. 2013. View Article : Google Scholar

29 

Tavares-Murta BM, Mendonça MA, Duarte NL, et al: Systemic leukocyte alterations are associated with invasive uterine cervical cancer. Int J Gynecol Cancer. 20:1154–1159. 2010. View Article : Google Scholar

30 

Imai Y, Kubota Y, Yamamoto S, et al: Neutrophils enhance invasion activity of human cholangiocellular carcinoma and hepatocellular carcinoma cells: an in vitro study. J Gastroenterol Hepatol. 20:287–293. 2005. View Article : Google Scholar

31 

McDonald B, Spicer J, Giannais B, Fallavollita L, Brodt P and Ferri LE: Systemic inflammation increases cancer cell adhesion to hepatic sinusoids by neutrophil mediated mechanisms. Int J Cancer. 125:1298–1305. 2009. View Article : Google Scholar

32 

Wu Y, Zhao Q, Peng C, Sun L, Li XF and Kuang DM: Neutrophils promote motility of cancer cells via a hyaluronan-mediated TLR4/PI3K activation loop. J Pathol. 225:438–447. 2011. View Article : Google Scholar : PubMed/NCBI

33 

Siddique A and Kowdley KV: Insulin resistance and other metabolic risk factors in the pathogenesis of hepatocellular carcinoma. Clin Liver Dis. 15:281–296. 2011. View Article : Google Scholar : PubMed/NCBI

34 

Oh JS, Kucab JE, Bushel PR, et al: Insulin-like growth factor-1 inscribes a gene expression profile for angiogenic factors and cancer progression in breast epithelial cells. Neoplasia. 4:204–217. 2002. View Article : Google Scholar

35 

Piecewicz SM, Pandey A, Roy B, Xiang SH, Zetter BR and Sengupta S: Insulin-like growth factors promote vasculogenesis in embryonic stem cells. PloS One. 7:e321912012. View Article : Google Scholar : PubMed/NCBI

36 

Brandau S, Dumitru CA and Lang S: Protumor and antitumor functions of neutrophil granulocytes. Semin Immunopathol. 35:163–176. 2013. View Article : Google Scholar

37 

Zhang JB, Chen Y, Zhang B, et al: Prognostic significance of serum gamma-glutamyl transferase in patients with intermediate hepatocellular carcinoma treated with transcatheter arterial chemoembolization. Eur J Gastroenterol Hepatol. 23:787–793. 2011. View Article : Google Scholar

38 

Oh BS, Jang JW, Kwon JH, et al: Prognostic value of C-reactive protein and neutrophil-to-lymphocyte ratio in patients with hepatocellular carcinoma. BMC cancer. 13:782013. View Article : Google Scholar : PubMed/NCBI

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Copy and paste a formatted citation
Spandidos Publications style
Zhang J, Gong F, Li L, Zhao M and Song J: Diabetes mellitus and the neutrophil to lymphocyte ratio predict overall survival in non‑viral hepatocellular carcinoma treated with transarterial chemoembolization. Oncol Lett 7: 1704-1710, 2014.
APA
Zhang, J., Gong, F., Li, L., Zhao, M., & Song, J. (2014). Diabetes mellitus and the neutrophil to lymphocyte ratio predict overall survival in non‑viral hepatocellular carcinoma treated with transarterial chemoembolization. Oncology Letters, 7, 1704-1710. https://doi.org/10.3892/ol.2014.1896
MLA
Zhang, J., Gong, F., Li, L., Zhao, M., Song, J."Diabetes mellitus and the neutrophil to lymphocyte ratio predict overall survival in non‑viral hepatocellular carcinoma treated with transarterial chemoembolization". Oncology Letters 7.5 (2014): 1704-1710.
Chicago
Zhang, J., Gong, F., Li, L., Zhao, M., Song, J."Diabetes mellitus and the neutrophil to lymphocyte ratio predict overall survival in non‑viral hepatocellular carcinoma treated with transarterial chemoembolization". Oncology Letters 7, no. 5 (2014): 1704-1710. https://doi.org/10.3892/ol.2014.1896
Copy and paste a formatted citation
x
Spandidos Publications style
Zhang J, Gong F, Li L, Zhao M and Song J: Diabetes mellitus and the neutrophil to lymphocyte ratio predict overall survival in non‑viral hepatocellular carcinoma treated with transarterial chemoembolization. Oncol Lett 7: 1704-1710, 2014.
APA
Zhang, J., Gong, F., Li, L., Zhao, M., & Song, J. (2014). Diabetes mellitus and the neutrophil to lymphocyte ratio predict overall survival in non‑viral hepatocellular carcinoma treated with transarterial chemoembolization. Oncology Letters, 7, 1704-1710. https://doi.org/10.3892/ol.2014.1896
MLA
Zhang, J., Gong, F., Li, L., Zhao, M., Song, J."Diabetes mellitus and the neutrophil to lymphocyte ratio predict overall survival in non‑viral hepatocellular carcinoma treated with transarterial chemoembolization". Oncology Letters 7.5 (2014): 1704-1710.
Chicago
Zhang, J., Gong, F., Li, L., Zhao, M., Song, J."Diabetes mellitus and the neutrophil to lymphocyte ratio predict overall survival in non‑viral hepatocellular carcinoma treated with transarterial chemoembolization". Oncology Letters 7, no. 5 (2014): 1704-1710. https://doi.org/10.3892/ol.2014.1896
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