Observational Study
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Oncol. Feb 15, 2024; 16(2): 372-385
Published online Feb 15, 2024. doi: 10.4251/wjgo.v16.i2.372
Prognostic value of circulating tumor cells combined with neutrophil-lymphocyte ratio in patients with hepatocellular carcinoma
Jia-Li Chen, Lu Guo, Zhen-Ying Wu, Kun He, Han Li, Chi Yang, Yun-Wei Han
Jia-Li Chen, Zhen-Ying Wu, Han Li, Yun-Wei Han, Department of Oncology, The Affiliated Hospital of Southwest Medical University, Luzhou 646000, Sichuan Province, China
Lu Guo, Department of Ophthalmology, The Affiliated Hospital of Southwest Medical University, Luzhou 646000, Sichuan Province, China
Kun He, Clinical Research Institute, The Affiliated Hospital of Southwest Medical University, Luzhou 646000, Sichuan Province, China
Chi Yang, Department of Plastic Surgery, Meguiar's Medical Beauty Hospital, Chengdu 610000, Sichuan Province, China
Co-first authors: Jia-Li Chen and Lu Guo.
Author contributions: Chen JL, Guo L, and Han YW conceived, designed and refined the study protocol; Wu ZY, Li H, and Yang C were involved in the data collection; He K analyzed the data; Chen JL, and Guo L drafted the manuscript; all authors were involved in the critical review of the results and have contributed to, read, and approved the final manuscript. Chen JL and Guo L contributed equally to this work. The reasons for designating Chen JL and Guo L as co-first authors are threefold. First, the research was performed as a collaborative effort, and the designation of co-first authorship accurately reflects the distribution of responsibilities and burdens associated with the time and effort required to complete the study and the resultant paper. This also ensures effective communication and management of post-submission matters, ultimately enhancing the paper's quality and reliability. Second, the overall research team encompassed authors with a variety of expertise and skills from different fields, and the designation of co-first authors best reflects this diversity. This also promotes the most comprehensive and in-depth examination of the research topic, ultimately enriching readers' understanding by offering various expert perspectives. Third, Chen JL and Guo L contributed efforts of equal substance throughout the research process. The choice of these researchers as co-first authors acknowledges and respects this equal contribution, while recognizing the spirit of teamwork and collaboration of this study. In summary, we believe that designating Chen JL and Guo L as co-first authors of is fitting for our manuscript as it accurately reflects our team's collaborative spirit, equal contributions, and diversity.
Institutional review board statement: This study complied with the guidelines of the Helsinki Declaration. The research protocol was approved by the Clinical Trial Ethics Committee of the Affiliated Hospital of Southwest Medical University (approval number: KY2021063) and registered in the Chinese Clinical Trial Registry (registration number: ChiCTR2100044198).
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: All authors have nothing to disclose.
Data sharing statement: The datasets generated during and/or analysed during the current study are available from the corresponding author on reasonable request.
STROBE statement: The authors have read the STROBE Statement—checklist of items, and the manuscript was prepared and revised according to the STROBE Statement—checklist of items.
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: Yun-Wei Han, MD, PhD, Professor, Researcher, Department of Oncology, The Affiliated Hospital of Southwest Medical University, No. 25 Taiping Street, Jiangyang District, Luzhou 646000, Sichuan Province, China. lanpaoxiansheng@126.com
Received: October 16, 2023
Peer-review started: October 16, 2023
First decision: December 6, 2023
Revised: December 6, 2023
Accepted: January 8, 2024
Article in press: January 8, 2024
Published online: February 15, 2024
Processing time: 108 Days and 18.9 Hours
ARTICLE HIGHLIGHTS
Research background

Patients with hepatocellular carcinoma (HCC) have a low benefit rate from immunotherapy. Clinical treatment lacks highly specific and sensitive prognostic biomarkers.

Research motivation

Investigation on whether the ratio of programmed death-ligand 1 (PD-L1) on circulating tumor cells (CTCs) combined with neutrophil-to-lymphocyte ratio (NLR) can serve as a biomarker for predicting the prognosis of immune combined targeted therapy in HCC.

Research objectives

Search for novel combined predictive biomarkers and apply them for risk stratification and clinical decision-making.

Research methods

This study adopts a method that combines clinical trials with data analysis.

Research results

HCC patients with high CTC PD-L1 (+) or NLR expression tend to exhibit poor prognosis, and a high baseline CTC-NLR score may indicate low survival.

Research conclusions

CTC-NLR may serve as an effective prognostic indicator for patients with advanced HCC receiving immunotherapy combined with targeted therapy.

Research perspectives

Future large-sample, multi-center studies are needed to further validate.