Tumor Biology

, Volume 36, Issue 11, pp 8797–8803 | Cite as

Imbalance in systemic inflammation and immune response following transarterial chemoembolization potentially increases metastatic risk in huge hepatocellular carcinoma

  • Tong-Chun Xue
  • Qing-An Jia
  • Ning-Ling Ge
  • Yi Chen
  • Bo-Heng Zhang
  • Sheng-Long Ye
Research Article


Inflammation plays a critical role in tumor metastasis. However, few inflammation-related biomarkers are currently available to predict the risk of metastasis for advanced hepatocellular carcinoma (HCC). Using huge tumors (diameter >10 cm) as a model, we evaluated the potential risk of pre- and post-treatment inflammatory responses in the development of metastasis of HCC patients undergoing transarterial chemoembolization (TACE). A logistic regression model was used to analyze the risk factors. One hundred and sixty-five patients with huge HCC were enrolled in the study. Metastases were identified in 25.5 % (42/165) patients by imaging evaluation post-TACE. Neutrophils increased, whereas lymphocytes decreased significantly post-TACE. Univariate analysis showed that high post-treatment neutrophil-to-lymphocyte ratio (NLR; p = 0.003), low post-treatment lymphocyte count (p = 0.047), and high baseline NLR (p = 0.100) were potential risk factors for metastasis. Further, multivariate analysis showed that high post-treatment NLR, but not pre-treatment NLR, was an independent risk factor for metastasis; this was confirmed by receiver operating characteristic curve analysis. Post-treatment NLR, however, had no correlation to tumor response and overall survival of patients. In conclusion, post-treatment NLR but not pre-treatment NLR independently increases the risk of metastasis in huge HCC. Our findings suggest the potential contribution of treatment-related inflammation to metastasis in advanced HCC.


Chemoembolization Hepatocellular carcinoma Immune Inflammation Metastasis 



This study was supported by the State Key Project on Infectious Diseases of China (No. 2012ZX10002-016) and the Shanghai Natural Science Foundation (No. 15ZR1407100).

Conflicts of interest



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Copyright information

© International Society of Oncology and BioMarkers (ISOBM) 2015

Authors and Affiliations

  • Tong-Chun Xue
    • 1
    • 2
  • Qing-An Jia
    • 3
  • Ning-Ling Ge
    • 1
    • 2
  • Yi Chen
    • 1
    • 2
  • Bo-Heng Zhang
    • 1
    • 2
    • 4
  • Sheng-Long Ye
    • 1
    • 2
  1. 1.Liver Cancer Institute, Zhongshan HospitalFudan UniversityShanghaiChina
  2. 2.Key Laboratory of Carcinogenesis and Cancer Invasion, Ministry of EducationFudan UniversityShanghaiChina
  3. 3.Institutes of Biomedical SciencesFudan UniversityShanghaiChina
  4. 4.Department of Medical Statistics, Zhongshan HospitalFudan UniversityShanghaiChina

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