The Value Of NLR,PLR,and Apparent Diffusion Coefficient(ADC)for Evaluating The Efficacy Of Transarterial Chemoembolization(TACE)on Patients With Hepatic Cell Carcinoma(HCC)

Objective:The NLR,PLR and PNI are united to evaluate the TACE efficacy for HCC treatment based on the ADC value.Method:This paper analyzes the clinical and imaging data of 77 HCC patients receiving TACE treatment from Oct.2017 to Dec.2018 in the second hospital of Dalian medical university.As per the serological information of patients 1 month before and after the operation,the ratio of neutrophile granulocyte and lymphocyte?NLR?,the ratio of blood platelet and lymphocyte?PLR?and the prognostic nutritional index?PNI?are calculated.The reviewed MRI image of patients one month before and after operation is adopted to measure the apparent diffusion coefficient?ADC?value.The patients are divided into two groups as per the evaluation criteria of improved solid tumor:the group with good efficacy:namely the complete remission?CR?patients,partial remission?PR?patients and stable disease?SD?patients,the group with poor TACE efficacy:namely the progressive disease?PD?patient.The logistic regression is used to calculate the predicted probability united by various indicators,and the receiver operating characteristic?ROC?method is applied to evaluate each indicator's value in evaluation of the alone TACE efficacy and the TACE efficacy by uniting HCC.Results:The overall NLR,PLR and PNI of the patients in group 1 month after operation have no obvious difference than those before operation?P>0.05?.The efficacy is good 1 month before and after operation and has on obvious difference among NLR group,PLR group and PNI group?P>0.05?.The efficacy is poor 1 month before and after operation and has on obvious difference among NLR group,PLR group and PNI group?P>0.05?.The NLR for the group with good efficacy before operation is lower than that for the group with poor efficacy?P<0.05?,and the NLR for the group with good efficacy 1 month after operation is lower than that for the group with poor efficacy?P<0.05?.The PLR for the group with good efficacy before operation is lower than that for the group with poor efficacy?P<0.05?,and the PLR for the group with good efficacy 1 month after operation is lower than that for the group with poor efficacy?P<0.05?.The PNI for the group with good efficacy before operation is higher than that for the group with poor efficacy?P<0.05?,and the PNI for the group with good efficacy 1 month after operation is higher than that for the group with poor efficacy?P<0.05?.The TACE's normal liver parenchyma value ADC of the patients in group before operation is similar to that one month after operation?P>0.05?,and the value ADC in tumor area 1 month after operation rises than that before operation?P<0.05?.The value ADC of TACE in tumor area before operation is obviously lower than that of normal liver parenchyma?P<0.05?,and the value ADC of TACE in tumor area 1 month after operation is higher than the value ADC of normal liver parenchyma?P<0.05?.The NLR,PLR and PNI 1 month before and after operation have the linear correlation before and after operation?P<0.05?.The value ADC 1month after operation has the linear correlation with the NLR and PLR after operation?P<0.05?.The diagnostic threshold of NLR before operation is 2.54,and the sensitivity and specificity for evaluation of TACE efficacy reaches 69.4%and 82.9%,respectively.The diagnostic threshold of NLR 1 month after operation is 2.63,and the sensitivity and specificity reach 75.0%and 70.7%,respectively.The diagnostic threshold of PLR before operation is 106.43,and the sensitivity and specificity reach 88.9%and 65.9%,respectively.The diagnostic threshold of PLR 1 month after operation is 104.70,and the sensitivity and specificity reach 77.8%and 94.4%,respectively.The diagnostic threshold of PNI before operation is 51.05,and the sensitivity and specificity reach 63.4%and 83.3%,respectively.The diagnostic threshold of PNI 1 month after operation is 50.11,and the sensitivity and specificity reach 65.9%and 70.7%,respectively.The diagnostic threshold of ADC before operation is 1.32×10^-3 mm²/s,and the sensitivity and specificity reach 46.3%and 77.8%,respectively.The diagnostic threshold of NLR after operation is 1.41×10^-3 mm²/s,and the sensitivity and specificity reach 87.8%and 98.9%,respectively.The sensitivity that ADC unites NLR before operation is the highest,and reaches 75.6%;The specificity that ADC unites PNI before operation is the highest,and reaches 88.9%;The sensitivity that ADC unites PNI after operation is the highest,and reaches 95.1%;The specificity that ADC unites NLR after operation is the highest,and reaches 97.2%.ConclusionThe value ADC,NLR,PLR and PNI of HCC patients is related to the TACE,which could be used to evaluate the TACE efficacy.The higher value ADC and PNI before operation and the lower NLR and PLR often mean better efficacy of TACE.The strong correlation exists between NLR and PLR,between PLR and PNI and between NLR and PNI.Certain correlation between ADC and NLR and between ADC and PNI.The value that ADC evaluates the TACE efficacy of HCC patients by uniting the NLR,PLR or PNI is higher than the alone evaluation value of NLR,PLR or PNI.The value that ADC evaluates the TACE efficacy of HCC patients by uniting the NLR,PLR or PNI is the highest.