Observational studyMedicine2017
Neutrophil-to-lymphocyte and aspartate-to-alanine aminotransferase ratios predict hepatocellular carcinoma prognosis after transarterial embolization.
Observational study in Medicine, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 37 papers, 3 of them syntheses that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
37 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Significant association between high neutrophil-lymphocyte ratio and poor prognosis in patients with hepatocellular carcinoma: a systematic review and meta-analysis.Frontiers in immunology · 2023Pooled it
- Neutrophil to lymphocyte ratio and albumin bilirubin grade in hepatocellular carcinoma: A systematic review.World journal of gastroenterology · 2020Pooled it
- Pooled it
- Aspartate Aminotransferase/Alanine Aminotransferase Ratio Predicts the Post-surgical Prognosis of Patients with Oral Squamous Cell Carcinoma.International dental journal · 2026Article
- The predictive value of NLR and PLR for TACE prognosis in hepatocellular carcinoma: a systematic review and meta-analysis.Open medicine (Warsaw, Poland) · 2026Review
- Inflammation and Immune-Based Scores Predict Prognosis for Patients with Hepatocellular Carcinoma: A Pilot Single-Center Study.The Turkish journal of gastroenterology : the official journal of Turkish Society of Gastroenterology · 2025Article
- Pregnancy cholestasis typically occurs in the third trimester of pregnancy and is a significant clinical condition.Archives of gynecology and obstetrics · 2024Article
- Combined DeRitis ratio and alkaline phosphatase on the prediction of portal vein tumor thrombosis in patients with hepatocellular carcinoma.Scientific reports · 2024Article
- Ferulic acid interventions ameliorate NDEA-CClToxicology reports · 2024Article
- Article
- Prognostic value of aspartate aminotransferase/alanine aminotransferase ratio in hepatocellular carcinoma after hepatectomy.BJS open · 2024Article
- The AST/ALT ratio predicts survival and improves oncological therapy decisions in patients with non-small cell lung cancer receiving immunotherapy with or without radiotherapy.Frontiers in oncology · 2024Article
- Dynamic Changes of Neutrophil-to-Lymphocyte Ratio on Predicting Response of Immune Checkpoint Inhibitors Plus Targeted Therapies for Unresectable Hepatocellular Carcinoma.Journal of hepatocellular carcinoma · 2024Article
- Association of AST/ALT ratio with 90-day outcomes in patients with acute exacerbation of chronic liver disease: a prospective multicenter cohort study in China.Frontiers in medicine · 2024Article
- Value of Preoperative Systemic Immune-Inflammation Index and Albumin-Bilirubin Grade in Patients with Hepatocellular Carcinoma Undergoing Transarterial Embolization.The Turkish journal of gastroenterology : the official journal of Turkish Society of Gastroenterology · 2023Article
- Therapeutic impact of purified Trichoderma viride L-asparaginase in murine model of liver cancer and in vitro Hep-G2 cell line.Journal, genetic engineering & biotechnology · 2023Article
- The prognostic role of the AST/ALT ratio in hepatocellular carcinoma patients receiving thermal ablation combined with simultaneous TACE.BMC gastroenterology · 2023Article
- Systemic Inflammation Score Using Pretherapeutic Inflammatory Markers to Predict Prognosis for Hepatocellular Carcinoma Patients After Hepatic Arterial Infusion Chemotherapy.Journal of hepatocellular carcinoma · 2023Article
- Transient Cytolysis after Transarterial Chemoembolization in Patients with Hepatocellular Carcinoma.Journal of personalized medicine · 2022Article
- A novel signature derived from metabolism-related genes GPT and SMS to predict prognosis of laryngeal squamous cell carcinoma.Cancer cell international · 2022Article
Corrections and comments
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Authors and funding
9 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
The neutrophil-to-lymphocyte ratio (NLR) reflects the systematic inflammatory status, and the aspartate aminotransferase-to-alanine aminotransferase ratio (AAR) is a biomarker of liver fibrosis and cirrhosis. These values can be conveniently obtained from routine blood tests; however, their combined clinical utility has not been extensively studied in patients with hepatocellular carcinoma (HCC) undergoing transarterial chemoembolization (TACE). This study aimed to investigate the prognostic value of NLR-AAR in patients with unresectable HCC undergoing TACE. Data for 760 patients with newly diagnosed HCC were retrospectively evaluated. The NLR-AAR was calculated as follows: patients in whom both the NLR and AAR were elevated according to the receiver operating characteristic (ROC) curve analysis were assigned a score of 2; patients showing an elevation in one or neither of these indicators were assigned a score of 1 or 0, respectively. Univariate and multivariate analyses were performed to identify the clinicopathological variables associated with overall survival. An ROC curve was also generated and the area under the curve (AUC) was calculated to evaluate the discriminatory ability of each index at 1, 3, and 5 years of follow-up, as well as overall. The NLR-AAR consistently had a greater AUC value at 1 year (0.669), 3 years (0.667), and 5 years (0.671) post-TACE compared with either NLR or AAR alone. The median survival times of patients with a NLR-AAR of 0, 1, and 2 were 31.0 (95% confidence interval [CI] 24.0-38.0), 15.0 (95% CI 11.2-18.8), and 5.0 (95% CI 4.0-5.9) months, respectively (P < .001). Multivariate analysis showed that the NLR-AAR, elevated total bilirubin level, and vascular invasion were independently associated with overall survival. NLR and AAR, when combined to produce an inflammation-based index and fibrosis score, is an independent marker of poor prognosis in patients with HCC receiving TACE.
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