Correlation Between Neutrophil And Lymphocyte Count Ratio And Microvascular Infiltration In Patients With Hepatocellular Carcinoma

Objective In this study,we evaluated the prevalence of neutrophils-to-lymphocytes ratio(NLR)in patients with hepatocellular carcinoma(HCC)and other relevant clinical factors to predict the presence of microvascular invasion(MVI)in HCC patients,and to develop the surgical methods and other adjuvant treatment options for patients in the future.Provide a basis to reduce the risk of tumor recurrence and improve long-term survival.Methods A retrospective analysis was performed on 61 patients who underwent radical resection of hepatocellular carcinoma at Chifeng Clinical Medical College of Inner Mongolia Medical University from January 2016 to December 2018,including 50 males and 11 females,23 to 71 years old,with an average of 55.3 ± 9.3 years.Among them,43 patients with hepatitis B and 9 patients with hepatitis C.According to the postoperative pathological report,the patients were divided into 26 cases of microvascular infiltration group and 35 cases without microvascular infiltration group(control group).The age,gender,neutrophils,lymphocytes,tumor diameter,alpha fetoprotein(AFP),aspartate aminotransferase,alanine aminotransferase and other related data were counted.The data were analyzed using SPSS25.0 statistical software.The cutoff value of NLR was determined by ROC curve.Firstly,single factor analysis was used,The t test(normal distribution,variance)and Mann-Whitney U test(non-normal distribution)were used for age,tumor diameter,AFP,The measurement data of alanine aminotransferase,aspartate aminotransferase,neutrophils,lymphocytes and NLR were analyzed,and the counts of gender,tumor diameter,AFP,History of hepatitis B,history of hepatitis C and NLR were analyzed by χ2 test.The meaningful factors in the single factor analysis: NLR,AFP,and tumor diameter are analyzed by multiple factor logistic regression to determine the independent risk factors of MVI.All of the above are based on α = 0.05,P<0.05 is considered statistically significant.Results According to the ROC curve,the critical value of NLR was 2.15,and there were 16 cases of NLR ≥ 2.15 in the MVP group,accounting for 61.5 %;A total of 8 cases of NLR ≥ 2.15 in the MVI group,accounting for 22.9 %;The proportion of NLR ≥ 2.15 in the MVP group was significantly greater than that of the no MVP group.The t-test and Mann-Whitney U test analysis showed that the differences in AFP(P=0.007),tumor diameter(P=0.001),and NLR(P=0.003)were statistically significant;There was no statistically significant difference in age(P=0.071),alanine aminotransferase(P=0.240),and glutamate aminotransferase(P=0.635).The chi-square analysis showed that there were significant differences in AFP(χ2=7.948,p=0.005),tumor diameter(χ2=7.916,p=0.005),and NLR(χ2=9.353,p=0.002).The difference is statistically significant;There is no statistical difference in the gender(χ2=0.044,p=0.834),history of hepatitis B(χ2=0.146,p=0.703)and the history of hepatitis C(χ2=1.797,p=0.180).Logistic regression analysis results in: NLR(OR 3.932;95 % CI 1.120-13.804;P=0.033),tumor diameter(OR 3.828;95 % CI 1.122-13.063;P=0.032)is an independent risk factor for hepatocellular carcinoma MVI;AFP(OR 4.003;95%CI 0.854-18.769;P=0.079)is not an independent risk factor for MVI.Conclusion 1.The threshold value of NLR obtained by the ROC curve is 2.15,When patients with hepatocellular carcinoma have a preoperative NLR ≥ 2.15,there is a greater likelihood of MVI,which can be used as a reference for evaluating the presence or absence of MVI in HCC patients.2.MVI is more likely to occur in patients with hepatocellular carcinoma before surgery with NLR,tumor diameter,and preoperative AFP.3.Preoperative NLR and tumor diameter are independent risk factors for hepatocellular carcinoma MVI.