Prognostic Value Of Preoperative Peripheral Blood Neutrophils To Lymphocyte Ratio And Platelets To Lymphocyte Ratio In Patients With Hepatocellular Carcinoma

Objective: To evaluate the prognostic value of preoperative peripheral blood neutrophils to lymphocyte ratio(NLR)and platelet to lymphocyte ratio(PLR)in patients with hepatocellular carcinoma(HCC).Medthods:The clinical data of 215 HCC patients admitted to the second affiliated hospital of nanchang university from February 2011 to December 2015 were retrospectively analyzed.NLR and PLR were calculated according to the routine neutrophil,lymphocyte and platelet count of peripheral blood in the first week before operation.Draw the ROC curves of NLR and PLR,and get the cut-off values of NLR and PLR through Youden index.According to the NLR and PLR thresholds,patients were divided into low NLR group and high NLR group,low PLR group and high PLR group.Combined with NLR and PLR,it was divided into high NLR-high PLR group,high NLR-low PLR group,low NLR-high PLR group,low NLR-low PLR group.The cumulative survival rate was calculated using the Kaplan-Meier method,and the difference of groups compared use the Log-rank,and COX regression analyzed the prognostic factors of hepatocellular carcinoma.Results:According to the ROC curve analysis,the critical value of NLR is2.665,and the critical value of PLR is 125.78.215 patients were divided into two groups according to the critical value,NLR < 2.665 group include 129 cases,NLR ≥2.665 group include 86 cases.Two groups in age,sex,HBsAg,Child-Pugh classification,tumor number,tumor size,AFP,TNM stage,distant metastasis,and intraoperative blood loss were no statistical differences.In the PLR<125.78 group,there were 122 cases,and there were 93 cases of PLR ≥125.78 group.Among them,there was no statistically significant difference between the groups in age,sex,Child-Pugh grading,tumor number,AFP and intraoperative blood loss.In the single-factor analysis,NLR≥2.665,PLR≥125.78,TNM stage III-IV,tumor size >5cm,vascular invasion,intraoperative blood loss≥800ml,intraoperative blood transfusion were risk factors for the overall survival of HCC patients(P<0.05).Moreover,HighNLR-High PLR were highly suggestive of poor prognosis of patients with HCC.COX regression multifactor analysis of NLR,TMN staging and intraoperative blood transfusion were independent risk factors affecting the overall survival.Conclusions:Preoperative NLR has a certain value in predicting the prognosis of patients with HCC.High NLR-High PLR can preferable predict poor prognosis of patients with HCC.