Preoperative Prognostic Nutrition Index(PNI) And Neutrophil/Lymphocyte Ratio(NLR) In Predicting Early Recurrence Of Hepatocellular Carcinoma After Operation

Objective:To investigate the preoperative nutritional assessment: the predictive value of PNI(prognosis nutritional index)and NLR(neutrophil/lymphocyte ratio)for early postoperative recurrence of liver cancer.Methods: The clinical data of 237 patients with hepatocellular carcinoma who underwent partial hepatectomy in anhui provincial hospitalfrom January 2012 to December 2015 and whose pathological findings were hepatocellular carcinoma were retrospectively analyzed.The PNI and NLR values were calculated according to the results of the patient’s 1 week preoperative examination.The PNI and NLR receiver operating characteristic(ROC)curves were plotted.The highest and low PNI groups were used to determine the boundary values of the high and low NLR groups.Patients were divided into high PNI group and low PNI group,high NLR group and low NLR group according to the cutoff value,analyze the relationship between PNI,NLR and clinicopathological features of liver cancer and early postoperative recurrence Results: In this study,128 patients had a high PNI group(≥45.95),109 patients had a low PNI(<45.95),99 patients had a high NLR group(≥2.52),and 138 patients had a low NLR group(<2.52).The overall survival rate was higher in the high PNI group than in the low PNI group(P<0.05).The overall survival rate was higher in the low NLR group than in the high NLR group(P<0.05).In this study,190 male patients(80%),female patients 47(20%),80 patients over 60 years old,157 people under 60 years old,median age 56 years,(25% to 75% age)The range is 44-63 years old,97 patients(40.9%)with tumor diameter >5cm,140 patients(59.1%)with diameter ≤5cm,119 patients(50.2%)with AFP>20,AFP≤20 The number of patients was 118(49.8%),the number of HBsAg-positive patients was 174(73.4%),the number of negative patients was 63(26.6%),and the number of patients with microvascular invasion after surgery was 58(24.5%).There were 179 patients(75.5%)with microvascular invasion;133(56%)patients with stage I/II stage TNM,and 104(44%)patients with stage III/IV.Univariate logistic regression analysis showed that PNI,NLR,tumor diameter,alpha fetoprotein(AFP),microvascular invasion and TNM staging were closely related to early recurrence after radical resection of liver cancer;multivariate logistic regression analysis showed high PNI and low NLR and more Late TNM staging is an independent risk factor for early recurrence after radical resection of liver cancer.The area under the curve of PNI and NLR measured by ROC curve was 0.86 and 0.56,respectively,both of which were greater than 0.5,indicating that PNI and NLR have diagnostic value.Conclusion: Preoperative PNI and NLR are independent risk factors for early postoperative recurrence of liver cancer patients.High PNI and low NLR have potential value in predicting early recurrence of liver cancer.