The Predictive Value Of Preoperative NLR?PLR And SII In Early Recurrence Of Tumor After Radical Resection Of Liver Cancer

PurposeEvaluating the predictive value of preoperative neutrophil-lymphocyte ratio(NLR),platelet-lymphocyte ratio(PLR)and systemic immune-inflammation index(SII)for early recurrence of tumor after radical resection of liver cancer MethodThe clinical data of 109 patients undergoing radical resection of liver cancer between March 2016 and January 2017 in the First Affiliated Hospital of Zhengzhou University were retrospectively analyzed.The NLR,PLR,and SII values were calculated base on the most recent blood routine results before surgery,and the ROC curve was plotted to determine the best cut off value.According to the best cut off value,the case data were divided into high NLR group and low NLR group,high PLR group and low PLR group,high SII group and low SII group,and comparing clinical data of patients with different level of NLR,PLR and SII.According to whether the recurrence of tumor after radical resection of liver cancer within 1 year,The patients were divided into early recurrence group and non-early recurrence group.The gender,age,preoperative ALT,maximum tumor size,microvascular invasion,preoperative AFP,child grade,pathological differentiation,and preoperative NLR,PLR,and SII were analyzed in the univariate model,And getting the possible risk factors for early recurrence of tumor after radical resection of hepatocellular carcinoma.The risk factors that shown by univariate analysis bing into the COX multivariate regression model to determine the independent risk factors of early recurrence after surgery.Draw the tumor-free survival rate curve within one year of independent risk factors,and comparing the difference of curves by the log-rank method.ResultThe area under the ROC curve was 0.725 based on the preoperative NLR value.The best cut off value for the preoperative NLR was 3.2.The sensitivity and specificity were respectively 70.2% and 71.2%.According to preoperative PLR values,the area under the ROC curve was 0.664,and the best cut off value of preoperative PLR was 117.9.The sensitivity and specificity were respectively 59.6% and 71.2%.Similarly,the area under the ROC curve was 0.739 based on the preoperative PLR value,the best cut off value was 360.9,and the sensitivity and specificity were respectively 82.5% and 57.7%.There are 57 patients in the early relapse group and 52 patients in the non-early relapse group.Univariate analysis showed that high NLR,high PLR,high SII,and microvascular invasion were the risk factors for early recurrence after radical resection of liver cancer.COX multivariate regression model analysis showed that high SII and microvascular invasion were the independent risk factors of early recurrence of tumor after radical resection of liver cancer.Log-rank method compared the tumor-free survival rate curve,and the results showed that the tumor-free survival rate of preoperative high SII group(SII>360.9)is significantly lower than the preoperative low SII group(SII?360.9),(P<0.05).The tumor-free survival rate of microvascular invasion was significantly lower than the patients without microvascular invasion,(P < 0.05).Conclusion1.The preoperative high SII level may be an independent risk factor for early recurrence of tumor after radical resection of liver cancer,and may have predictive value for early recurrence of postoperative tumor.2.Preoperative high NLR and high PLR levels may not be independent risk factors for early recurrence of tumor after radical resection of liver cancer,and may not have predictive value for early recurrence of postoperative tumors.