| Purpose: To investigate the predictive value of preoperative peripheral blood neutrophil to lymphocyte ratio(NLR),monocyte to lymphocyte ratio(MLR)and systemic inflammatory response index(SIRI,neutrophil to monocyte/lymphocyte)for early tumor recurrence in patients with hepatocellular carcinoma after radical resection.Method: A retrospective analysis was conducted on the clinical data and postoperative follow-up of 171 patients who underwent radical resection of hepatocellular carcinoma in the first affiliated hospital of guangxi medical university from January 2015 to June 2016 and were confirmed as hepatocellular carcinoma by postoperative pathology.According to preoperative patients with a recent routine blood in the peripheral blood test results calculated NLR,MLR and SIRI value,through the system of painting subjects work curve(ROC curve)and calculating about index(Youden index),combined with the sensitivity and specificity of the optimum threshold of NLR,MLR and SIRI,and this value is bounded divided the patients into low NLR group and high NLR,low MLR group and high MLR,low SIRI group and high SIRI,then two groups of NLR,the clinical data of patients with MLR,SIRI comparative analysis.Early relapse group and the early recurrence group of patients with hepatocellular carcinoma(HCC)whether relapse within 2 years after radical resection group as the standard,by single factor analysis,two groups of patients’ age,sex,tumor number,diameter of tumor,pathologic stage,microvascular invasion,cirrhosis of the liver,hepatitis B virus surface antigen(HBsAg),Barcelona stage(BCLC staging),preoperative alph fetal protein(AFP),preoperative cereal third transaminase(ALT),preoperative albumin(ALB)and preoperative NLR,MLR and SIRI,that may cause cancer early postoperative recurrence of hepatocellular carcinoma risk factors.Then,COX multivariate regression model was used to analyze these risk factors,so as to determine independent risk factors closely related to early postoperative tumor recurrence.Kaplan-meier method was used to draw the tumor-free survival curve of patients within 2 years after surgery,and the difference of tumor-free survival curve was compared by log-rank method.Result: The area under the ROC curve of the preoperative NLR value was 0.622,and the optimal critical value of the preoperative NLR was 1.82 when the Youden index was the maximum.The area under the ROC curve of preoperative MLR value was 0.589,and the optimal critical value of preoperative MLR was 0.35.Similarly,the area under the ROC curve of preoperative SIRI value was 0.580,and the optimal critical value of preoperative SIRI value was 1.27.Number of patients with early recurrence with the early recurrence group 67 cases and 104 cases respectively,and the single factor analysis showed that tumor diameter,BCLC staging,pathologic stage,microvascular invasion and preoperative high NLR,high MLR,high SIRI is hepatocellular carcinoma risk factors for early recurrence after radical resection of tumor,COX,the multi-factor regression model analysis showed that tumor with large diameter and high,pathologic stage and high NLR is with early tumor recurrence after radical resection of hepatocellular carcinoma is closely related to the independent risk factors.The log-rank method was used to compare the tumor-free survival curve,and the results showed that the tumor-free survival rate of patients with large tumor diameter(> 5cm)in 2 years was significantly lower than that of patients with small tumor diameter(≤5cm)(P < 0.001).The tumor free survival rate of patients with high postoperative pathological grade was significantly lower than that of patients with low postoperative pathological grade(P < 0.001).Patients in the high preoperative NLR group(NLR > 1.82)had significantly lower tumor-free survival rate within 2 years after surgery than those in the low preoperative NLR group(NLR≤1.82)(P < 0.001).Conclusions: Preoperative high level of NLR in peripheral blood is an independent risk factor for early recurrence of hepatocellular carcinoma after radical resection.The early recurrence rate of hepatocellular carcinoma patients after radical resection is higher than the critical value of 1.82.It has certain value for predicting early recurrence of hepatocellular carcinoma after radical resection.Preoperative high level of MLR and high SIRI are not independent risk factors,and may not have any effect on early recurrence of hepatocellular carcinoma after radical resection Prepare for predictive value. |
