Afro-Egypt J Infect Endem Dis 2015 June ; 5(3):143

 

Efficacy of Using Neutrophil to Lymphocyte Ratio and Interleukin 6 as Outcome Predictors of Interventional Treatment of Hepatocellular Carcioma

 

El-Ghoneimy SM,Soliman AM, Azab MM, El-Gebaly AM,Abdel Monem SM

Tropical Medicine Department, Faculty of Medicine, Zagazig University, Egypt

icegebo2011@yahoo.com

 

ABSTRACT

Background and study aim :Hepatocellular carcinoma (HCC) is currently the fifth most common solid tumor worldwide and the third leading cause of cancer-related death. Percutaneous ethanol injection (PEI) and radiofrequency ablation (RFA) techniques became well-known procedures for controlling small HCC. Inflammation is a major contributing factor to carcinogenesis specially HCC. Inflammatory mediators including interleukin-6 (IL-6) and neutrophil to lymphocyte ratio (NLR) are good candidates to stimulate tumor growth and progression. The aim of this study was to evaluate validity of using NLR and IL-6 as predictors of outcome of interventional treatment for HCC. .

Patients and Methods: This study was conducted on 136 patients with 145 focal nodular HCCs of 5 cm or less between 2012 and 2015. They were divided into 2 groups, the first group included 72 patients whom had NLR less than 5 and the second group included 64 patients whom had NLR equal or more than 5. Patients underwent PEI or RFA. Clinical assessment, laboratory evaluation and triphasic CT studies were performed to all patients pre-treatment and at 1, 6 and 12 months post treatment. NLR and IL-6 level were performed to all patients pre treatment and at 6 months post treatment.

Results: The percentage of complete ablation is highly significantly higher in group I after 1 month but, there is no significant difference between outcome of treatment after 1 year in both groups one year after treatment. Post-procedural IL-6 showed highly significantly lower levels in patients whose focal lesions remain ablated till 1 year than in those who showed multifocal or local recurrence, while NLR did not show significant difference among these groups. Post-prcedural IL-6 levels were highly significantly lower in survived than died cases, while NLR did not show significant differences between both groups at 1 year follow up. There was no significant difference in the post-procedural level of NLR or IL-6 between the group who was treated with ethanol injection and who was treated with radiofrequency ablation as regard the overall outcome at 1 year follow up.

Conclusion: Pre-procedural NLR is a good indicator of performance status, liver profile, hematological profile and diameter of focal HCC and also is a good predictor for short term outcome (1-6 months) and neither pre-procedural or post-procedural NLR are predictors of long term outcome or survival (1 year). Post-procedural IL-6 could be considered as a good predictor not only for survival, but also for efficacy of treatment.