Preoperative Neutrophil-lymphocyte Ratio On The Prognosis Of The Patients With Hepatocellular Carcinoma

Objective: Retrospective analysis and summarize the relationship between preoperative neutrophil-lymphocyte ratio and prognosis of hepatocellular carcinoma, and probe the relationship between other relevant clinical characteristics and prognosis.Methods: The study was conducted at the Department of Hepatobiliary Surgery in the Fourth Affiliated Hospital of Hebei Medical University in China from January 2011 to December 2014. 339 cases were chosen to retrospective analysis the relationship between preoperative neutrophil-lymphocyte ratio(NLR) and prognosis, and obtained the informations that if the patients still survival and the survival time by telephone. Based on the median 2.43 divided the cases into two groups, respectively are high NLR group(?2.43) and low NLR group(<2.43). And then explore the relevance of relevant clinical characteristics and prognosis, include gender, age, PLT, Child-Pugh, ATL, AST, TBIL, ALB, AFP, tumor count, TNM staging, whether blood transfusion, carcinoma cell embolus and so on. Use the Kaplan-Meier method for univariate analysis, use Log-rank method for survival curve to univariate annlysis, and the meaningful results will be analysised by the Cox regression model with multivariate statistical.Results:1 The 1-year, 3-year and 5-year survival rates respectively were 84.4%, 64.1% and 55.9% of the whole team group, in the study, there are 170 cases from high NLR group(50.1%), and there are 169 cases from low NLR group(49.9%). Among them, the high NLR group 1-year, 3-year and 5-year survival rates respectively were 81.2%, 57.8% and 46.2%, the survival rates in the low NLR group were 87.6%, 70.8% and 67.8% respectively. Compared the survival curve of the two groups, the difference between the NLR level before surgery and prognosis was statistically significantly(P<0.05).2 The difference between the NLR level before surgery and hypersplenism weren't statistically significant.3 The clinical characteristics wasn't statistically significant between the high NLR group and the low NLR group.4 Analysis the difference between characteristics, the univariate analysis in relevant clinical characteristics show that the difference between AST, ALB, AFP, TNM staging, and carcinoma cell embolus and prognosis was statistically significant(P<0.05).5 The multivariate analysis confirmed the results that the NLR, ALB, AFP and TNM staging were independent prognostic factors which can affect the prognosis of resected hepatocellular carcinoma patients.Conclusions:1 Hypersplenism impacts little on the preoperative NLR who underwent surgical intervention.2 The higher the preoperative neutrophil-lymphocyte ratio(NLR) of the hepatocellular carcinoma patients, the worse prognosis.3 The preoperative neutrophil-lymphocyte ratio(NLR), ALB, AFP and TNM staging are the independent prognostic factors which affecting the prognosis with resected hepatocellular carcinoma patients, and combined the NLR with other clinical characteristics will contribute to assess prognosis.