| Objective: To investigate the relationship between preoperative neutrophil to lymphocyte ratio（NLR）and platelet to lymphocyte ratio（PLR）and the prognosis of patients with barcelona clinical staging of liver cancer（BCLC）stage B liver cancer treated by transcatheter arterial chemoembolization（TACE）.Methods: The clinical data of 98 patients diagnosed with BCLC stage B liver cancer and treated with TACE in Department of Hepatobiliary Surgery,Enshi Tujia and Miao Autonomous Prefecture Central Hospital from January 1,2015 to December 31,2020 were collected and analyzed retrospectively.The receiver operating characteristic（ROC）curves of preoperative NLR and PLR were drawn to determine the optimal cut-off value of the two,and divided into high and low groups based on the optimal cut-off value,and the low and high groups were defined as 0 and 1,the NLR-PLR score can be obtained by calculating the sum of the scores of the NLR group and the PLR group,and the patients were divided into three groups: NLR-PLR 0 group,NLR-PLR 1 group and NLR-PLR2 group.The area under the ROC curve of NLR and PLR was calculated,and their ability to predict the prognosis of patients with BCLC stage B liver cancer after TACE treatment was compared.The survival curves of NLR,PLR and NLR-PLR were drawn by Kaplan-Meier method and the survival time was analyzed.Log-rank univariate analysis was performed on clinical data to screen out the initial factors affecting the prognosis of patients,and Cox proportional risk regression model was used to select the independent factors affecting the prognosis of patients.Results:（1）According to the ROC curves of NLR and PLR,the Youden indices of the two were calculated to obtain the best boundary values of 36.5 and 106.64,respectively,and the areas under the ROC curves were 0.72 and 0.58,respectively.The 1-year,2-year and 3-year survival rates of the high and low NLR groups were 47.50%,5.00%,0% and 86.21%,48.28% and 22.41%,respectively,and the mean survival time was 12.35 months and25.57 months,respectively.The 1-year,2-year and 3-year survival rates of high and low PLR groups were 61.42%,20.00%,5.71% and 92.86%,57.14% and 32.14%respectively,and the average survival time was 16.44 months and 30.71 months respectively.The 1-year,2-year and 3-year survival rates of NLR-PLR 0 group,NLRPLR 1 group and NLR-PLR 2 group were 92.59%,59.26%,33.33%,81.82%,36.36%,12.12% and 47.37%,5.26%,0%,respectively,and the mean survival time was 31.33 months,20.91 months and 12.5 months,respectively.（2）Univariate analysis showed that preoperative NLR,preoperative PLR,Child-Pugh grade and NLR-PLR score were all prognostic factors of patients with BCLC stage B liver cancer treated by TACE（P<0.05）.The median survival time of low and high NLR groups was 27 months and 11 months respectively.The median survival time of low and high PLR groups was 27 months and 14 months respectively,and the median survival time of Child-Pugh grade A and B was 23 months and 10 months respectively.The median survival time of NLRPLR 0 group,NLR-PLR 1 group and NLR-PLR 2 group was 28 months,20 months and 11 months respectively.There was no significant difference between NLR-PLR 0group and NLR-PLR 1 group,but there was a difference between NLR-PLR 0 group and NLR-PLR 2 group（P<0.001）.（3）Multivariate analysis showed that preoperative NLR and Child-Pugh grades were independent risk factors affecting the prognosis of patients with BCLC stage B liver cancer treated by TACE（P< 0.05）.Conclusions:（1）The prognosis of patients with BCLC stage B liver cancer in the preoperative high NLR group or PLR group after TACE treatment was poor.（2）Compared with preoperative PLR,preoperative NLR has stronger prognostic predictive ability in BCLC stage B liver cancer patients treated with TACE,and is also an independent risk factor affecting the prognosis of patients.（3）Univariate analysis within the NLR-PLR group showed that preoperative NLR or PLR above the cutoff had little effect on the survival of patients;but when both are above the cut-off value,it predicts patients have poor prognosis and short survival time.（4）There is great heterogeneity among BCLC stage B liver cancer patients,so the survival time after TACE treatment is also quite different.NLR and PLR are closely related to the prognosis of BCLC stage B liver cancer patients,and have certain prognostic value. |
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