Correlation Between Preoperative Neutrophil To Lymphocyte Ratio And Platelet To Lymphocyte Ratio And Prognosis Of Hepatocellular Carcinoma

Objective:To investigate the prognostic value of preoperative neutrophil to lymphocyte ratio(NLR)and platelet to lymphocyte ratio(PLR)in patients with hepatocellular carcinoma.Methods:The clinical data of 124 patients with hepatocellular carcinoma who underwent radical resection of liver cancer in our medical group and met the inclusion criteria from January 2013 to January 2019 were retrospectively analyzed.Telephone follow-up and outpatient follow-up were conducted according to the contact information registered on the first page of medical record.According to the venous blood routine results of the patients within 1 week before the operation,NLR and PLR were calculated.The calculation formula of NLR was the number of neutrophil/lymphocyte.PLR is calculated by the platelet count/lymphocyte count.The receiver operating characteristic(ROC)curves of NLR and PLR were drawn,and the optimal cut-off value was selected by the highest Youden index.According to the cut-off value,patients were divided into high NLR group and low NLR group,high PLR group and low PLR group.The survival curve was completed by Kaplan-Meier and tested by log-rank.Cox model carried out univariate and multivariate analysis on each variable to obtain the risk factors affecting the prognosis of patients and their independent risk factors.P<0.05 was considered statistically significant.Results:The median age of the 124 patients included in the study was 56 years with an average age of 54.93±10.36 years,including 96 males(77.4%)and 28 females(22.6%).HbsAg:112 positive cases,12 negative cases;Child-Pugh grade:119 cases of grade A,5 cases of grade B;AFP level(ng/mL):<400 in 86 cases,?400 in 38 cases;maximum tumor diameter:?5cm in 63 cases,>5cm in 61 cases;the number of tumors:108 with single occurrence and 16 with multiple occurrence;TNM staging:108 cases in ?/? stage,16 cases in ?/? stage.There were 24 cases of micro vascular invasion and 100 cases of non-vascular invasion.There were 11 cases with ascites and 113 cases without ascites.There were 35 cases of intraoperative blood transfusion and 89 cases without intraoperative blood transfusion.The ROC diagnostic curve was drawn and the optimal cut-off values of NLR and PLR were 1.86 and 114.80,respectively.There were 79 patients in the high NLR group(NLR?1.86)and 45 patients in the low NLR group(NLR<1.86).There were no statistical differences in age,gender,HbsAg,Child-Pugh grade,transaminase level,AFP level,tumor number and size,TNM stage,ascite and intraoperative blood transfusion between the two groups.There were 96 patients in the high PLR group(PLR?114.80)and 28 patients in the low PLR group(PLR<114.80),and there were no statistical differences in age,gender,HbsAg,Child-Pugh grade,transaminase level,AFP level,tumor number,differentiation degree and ascites.Univariate analysis showed that NLR,PLR,intraoperative blood transfusion,TNM stage and vascular invasion were univariate factors influencing the prognosis of patients(P<0.05).Further Cox risk model analysis showed that TNM staging(HR=2.802,95%CI=1.071-7.331,P<0.05)and NLR(HR=2.891,95%CI=1.287-6.495,P<0.05)were independent risk factors affecting the prognosis of HCC.Conclusion:HCC patients with high preoperative NLR(NLR?1.86)had poor prognosis,and preoperative NLR level could be used as a prognostic indicator in the patients with HCC.