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Alanine aminotransferase to hemoglobin ratio is an indicator for disease progression for hepatocellular carcinoma patients receiving transcatheter arterial chemoembolization

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Tumor Biology

Abstract

The prognosis of hepatocellular carcinoma (HCC) patients receiving transcatheter arterial chemoembolization (TACE) is far from being identified. The present study aimed to assess the role of blood cell counts, routine liver function tests, and alanine aminotransferase to hemoglobin ratio (AHR) in predicting the progression-free survival (PFS) of these patients. A total of 243 HCC patients receiving TACE were analyzed retrospectively. Cancer of the Liver Italian Program (CLIP) score system was indentified to be the best score system for this patient subgroup according to the Akaike information criterion (AIC) index and linear trend χ 2. Then, prognostic value of parameters was determined by integration into the CLIP score system. As a result, AHR was confirmed to be an independent predictor for the PFS of HCC patients receiving TACE (p = 0.001) with the other parameters failing to reach statistical significance. Moreover, AHR improved the performance of CLIP by adjusting into it, thus improving its discriminatory ability. AHR defined ≤0.4583 as low level and >0.4583 as high level. And, patients were also dichotomized into two groups accordingly. HCC patients receiving TACE with low AHR presented higher 1 year DCR (41.9 vs 18.1 %) compared with patients with high AHR levels. Furthermore, AHR level was associated with prognostic factors such as lower ALP, total bilirubin, and portal vein thrombosis. In summary, the present study firstly indentified AHR as an independent prognostic factor in HCC patients receiving TACE. The subgroup of HCC patients with lower AHR presented preferable disease control and were the idealistic candidates for TACE.

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Conflicts of interest

None

Financial support

This work was supported by grants from the National Natural Science Foundation of China (Nos. 81372374, 81172193, 81402426, and 81402509), China Postdoctoral Science foundation (2014M560689) and the Natural Science Foundation of Guangdong (No. 2014A030313146).

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    Authors and Affiliations

    1. Department of Medical Oncology, The Third Affiliated Hospital of Sun Yat-sen University, 600 Tianhe Road, Guangzhou, 510630, China

      Zhi-Huan Lin, Xing Li, Ying-Fen Hong, Xiao-Kun Ma, Dong-Hao Wu, Zhan-Hong Chen, Jie Chen, Min Dong, Li Wei, Tian-Tian Wang, Dan-Yun Ruan, Ze-Xiao Lin, Jing-Yun Wen, Xiang-Yuan Wu & Qu Lin

    2. Department of Radiology, The Third Affiliated Hospital of Sun Yat-sen University, 600 Tianhe Road, Guangzhou, 510630, China

      MingSheng Huang

    3. Department of Medical Oncology, Shenzhen People’s Hospital, 1017 Dongmenbei Road, Shenzhen, 518020, China

      Xiang Zhong

    4. Department of Nephrology, The Third Affiliated Hospital of Guangzhou Medical University, 63 Duobao Road, Guangzhou, 510150, China

      Yan-Fang Xing

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    1. Zhi-Huan Lin
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    Correspondence to Xiang-Yuan Wu or Qu Lin.

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    Zhi-Huan Lin and Xing Li contributed equally to this work.

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    Lin, ZH., Li, X., Hong, YF. et al. Alanine aminotransferase to hemoglobin ratio is an indicator for disease progression for hepatocellular carcinoma patients receiving transcatheter arterial chemoembolization. Tumor Biol. 37, 2951–2959 (2016). https://doi.org/10.1007/s13277-015-4082-y

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