Article Abstract

Neutrophil to lymphocyte ratio but not ring enhancement could predict treatment response and new lesion occurrence in patients with hepatocellular carcinoma by drug eluting beads transarterial chemoembolization

Authors: Shihong Ying, Xianyong Zhou, Shaolin Gong, Zhiyi Peng

Abstract

Background: To investigate the association of ring enhancement with neutrophil to lymphocyte ratio (NLR) and the predicting values of ring enhancement and NLR for treatment response and new lesion occurrence in hepatocellular carcinoma (HCC) patients post drug eluting beads transarterial chemoembolization (DEB- TACE).
Methods: Sixty- ve consecutive HCC patients received DEB-TACE by CalliSpheres® were enrolled and. Clinical responses were assessed by mRECIST criterion. Ring enhancement was assessed at 4–6 weeks and NLR was assessed within 24 hours post treatment. New lesion was evaluated at last follow up of each patient. Overall response rate (ORR) was the percentage of patients achieved complete response (CR) and partial response (PR).
Results: After DEB-TACE, CR and ORR were 18.5% and 87.7%, respectively. Additionally, ring enhancement was not correlated with absolute neutrophil count (ANC), lymphocytes (LYM) or NLR. No difference was found regarding CR, ORR or new lesion between patients with or without ring enhancement. In addition, the ANC of patients in CR group was lower compared to non-CR group, and patients with lower NLRs were likely to achieve better CR and less new lesion. Subgroup analysis disclosed that patients with multifocal lesions and higher Barcelona Clinic Liver Cancer (BCLC) stage were of worse CR.
Conclusions: NLR but not ring enhancement post treatment could predict treatment response and new lesion occurrence of patients with HCC treated by DEB-TACE.