Zhang Y, Chen P, Zhu X. Lymphocyte-to-white blood cell ratio is associated with outcome in patients with hepatitis B virus-related acute-on-chronic liver failure. World J Gastroenterol 2023; 29(23): 3678-3687 [PMID: 37398886 DOI: 10.3748/wjg.v29.i23.3678]
Corresponding Author of This Article
Xuan Zhu, PhD, Professor, Department of Gastroenterology, Jiangxi Clinical Research Center for Gastroenterology, The First Affiliated Hospital of Nanchang University, Yongwaizhengjie Road, Donghu District, Nanchang 330006, Jiangxi Province, China. waiyongtg@163.com
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Retrospective Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastroenterol. Jun 21, 2023; 29(23): 3678-3687 Published online Jun 21, 2023. doi: 10.3748/wjg.v29.i23.3678
Lymphocyte-to-white blood cell ratio is associated with outcome in patients with hepatitis B virus-related acute-on-chronic liver failure
Yue Zhang, Peng Chen, Xuan Zhu
Yue Zhang, Peng Chen, Xuan Zhu, Department of Gastroenterology, Jiangxi Clinical Research Center for Gastroenterology, The First Affiliated Hospital of Nanchang University, Nanchang 330006, Jiangxi Province, China
Author contributions: Zhang Y and Chen P contributed equally to this study, and they wrote the original draft; Zhang Y designed this study; Chen P analyzed the data; Zhu X critically revised the manuscript; and all authors have read and approved the final manuscript.
Supported bythe National Natural Science Foundation of China, No. 81960120 and 81660110; the Postgraduate Innovation Special Foundation of Jiangxi Province, No. YC2022-B052; and “Gan-Po Talent 555” Project of Jiangxi Province, No. GCZ (2012)-1.
Institutional review board statement: The study was reviewed and approved by the First Affiliated Hospital of Nanchang University Institutional Review Board (Approval No. IIT2021009).
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: Data can be acquired from the corresponding author.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Xuan Zhu, PhD, Professor, Department of Gastroenterology, Jiangxi Clinical Research Center for Gastroenterology, The First Affiliated Hospital of Nanchang University, Yongwaizhengjie Road, Donghu District, Nanchang 330006, Jiangxi Province, China. waiyongtg@163.com
Received: March 22, 2023 Peer-review started: March 22, 2023 First decision: April 14, 2023 Revised: April 28, 2023 Accepted: May 22, 2023 Article in press: June 21, 2023 Published online: June 21, 2023 Processing time: 85 Days and 20.5 Hours
ARTICLE HIGHLIGHTS
Research background
The lymphocyte-to-white blood cell ratio (LWR) is a blood marker that reflects the systemic inflammatory response. The prognostic value of the LWR remains unclear in hepatitis B virus-associated acute-on-chronic liver failure (HBV-ACLF) patients.
Research motivation
It is necessary to find an easy and effective marker that can reflect the prognosis in HBV-ACLF patients, so we explored whether LWR can risk-stratify poor prognosis in HBV-ACLF patients.
Research objectives
This study aimed to investigate whether LWR could be an easy and useful marker that can identify the risk of poor outcomes in HBV-ACLF patients.
Research methods
A total of 330 HBV-ACLF patients were included in this study, and patients were divided into survivor and non-survivor groups according to 28-d outcome. Univariate and multivariate Cox regression analyses were performed to select independent risk factors for 28-d mortality. The correlation test was performed to evaluate the correlation between LWR and Child-Turcotte-Pugh score (CTPs), model for end-stage liver disease score (MELDs), and Chinese Group on the Study of Severe Hepatitis B-ACLF II score (COSSHACLFIIs). The cutoff value of LWR was calculated by X-tile software, and Kaplan-Meier analysis was performed to assess the association of the LWR level and 28-d outcomes in HBV-ACLF patients.
Research results
Low LWR was an independent risk factor for 28-d mortality in patients with HBV-ACLF (hazard ratio = 0.052, 95% confidence interval: 0.005-0.535), and LWR levels were significantly negatively correlated with CTPs, MELDs and COSSHACLFIIs. Moreover, the patients with low LWR levels had a higher 28-d mortality than those with high LWR levels.
Research conclusions
LWR is a simple, useful, and effective marker that could stratify the risk of 28-d adverse outcomes in HBV-ACLF patients.
Research perspectives
Further large-sample and multicenter prospective studies should be conducted to verify and confirm the prognostic value of the LWR.
