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Neutrophils: driving progression and poor prognosis in hepatocellular carcinoma?

Lookup NU author(s): Dr Jane Margetts, Laura Ogle, Dr Anthony Chan, Dr David Jamieson, Dr Catherine WilloughbyORCiD, Professor Derek Mann, Dr Caroline WilsonORCiD, Professor Derek Manas, Professor Helen ReevesORCiD



This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International (CC BY-NC-SA 4.0).


Background Irrespective of the underlying aetiology, 90% of hepatocellular carcinomas(HCC) arise and progress on a background of chronic inflammation. We have explored theindependent prognostic value of circulating inflammatory cells.Methods Peripheral blood count datasets from 583 consecutive patients presenting to asingle UK centre (2000–2010) were analysed for associations with tumour stage, liverfunction, performance status (PST) and survival. Validation was in an independent HongKong cohort (585 patients; 2007-2013).Results In both UK and Hong Kong cohorts, neutrophils, platelets, lymphocytes, theneutrophil/lymphocyte ratio (NLR), and the Systemic immune-inflammation index (SII)correlated stepwise, either increasing or decreasing (lymphocytes), with TNM and Childs-Pugh stage, PST and consequently with the combined Barcelona Clinic for Liver Cancer(BCLC) stage. Survival analyses confirmed the NLR and SII as highly significant prognosticbiomarkers. Focused on individual cell types, only the neutrophil count was independentlyassociated with both TNM stage and PST, as well as being significantly and independentlyassociated with poorer survival.Conclusion In this study of 1168 patients, neutrophils alone, rather than lymphocytes orplatelets, were independently associated with outcome. These data support furthercharacterisation of a potentially distinctive role for neutrophils as facilitators of tumourprogression and deteriorating performance.

Publication metadata

Author(s): Margetts J, Ogle LF, Chan SL, Chan AWH, Chan KCA, Jamieson D, Willoughby CE, Mann DA, Wilson CL, Manas DM, Yeo W, Reeves HL

Publication type: Article

Publication status: Published

Journal: British Journal of Cancer

Year: 2018

Volume: 118

Pages: 248-257

Online publication date: 09/11/2017

Acceptance date: 09/10/2017

Date deposited: 28/11/2017

ISSN (print): 0007-0920

ISSN (electronic): 1532-1827

Publisher: Nature Publishing Group


DOI: 10.1038/bjc.2017.386


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