| Objective:To explore the relationship betweenneutrophil-to-lymphocyte ratio(NLR)?platelet-to-lymphocyte ratio(PLR)?monocyte-to-lymphocyte ratio(MLR)or Systemic Immune-Inflammation Index(S?)and the clinicopathologic features in hepatocellular carcinoma.Methods:1.Retrospective analysis was performed on the preoperative inflammatory indicators,postoperative pathological analysis and other clinical data of 205 patients who underwent radical resection of primary hepatocellular carcinoma in Nanchong central hospital from January 2016 to October 2019.Meanwhile,154 healthy subjects with gender and age matching were selected as the control group for comparative analysis.2.The values of NLR,MLR,PLR and S? were calculated according to the results of peripheral blood routine examination within 3 days before surgery.The Youden index was calculated by mapping ROC curve,obtaining the cut off values of NLR,MLR,PLR and S? accoording to the sensitivity and specificity,and all patients were divided into the low NLR group and the high NLR group,the low MLR group and the high MLR group,the low PLR group and the high PLR group,the low S? group and the high S? group.Then the clinical data of each group were compared and analyzed.3.The ROC curve analysis was used to calculate the cut off value,sensitivity and specificity of NLR,MLR,PLR and S? at different TNM stages of HCC.4.Statistical analysis was performed using SPSS22.0 statistical software.Results:1.A total of 205 patients with primary hepatocellular carcinoma were enrolled,including 127 males(61.95%)and 78 females(38.05%).All patients were aged 21-77 years,with an average age of 57.67±12.75 years and a BMI of 22.28±2.61 Kg/m2.A total of 154 healthy controls were selected,including 96 males(62.34%)and 58 females(37.66%),aged 19-78 years,with an average age of 55.25±12.63 years.There was no significant difference in gender composition ratio(?2=2.602,P=0.117)and age distribution(t=1.787,P=0.075)between the two groups(P>0.05).The NLR,MLR,PLR and S? of hepatocellular carcinoma group were higher than those of the healthy control group,with statistically significant differences(P<0.05).2.The cut off value of preoperative NLR was 2.571,the sensitivity was 57.07%,and the specificity was 79.22%.The cut off value of preoperative MLR was 0.302,the sensitivity was 51.22%,and the specificity was 85.71%.The cut off value of preoperative PLR was 136.399,the sensitivity was 46.83%,and the specificity was 83.12%.The cut off value of S? was 402.479,the sensitivity was 59.02%and the specificity was 66.88%.Spearman correlation test was used to analyze the results.There was no statistically significant difference in age,BMI,HBsAg,preoperative AFP and performance status between the high and low NLR groups(P>0.05).There were statistically significant differences among gender,child-pugh grade,tumor maximum diameter,vascular invasion,tumor number,cirrhosis,albumin,and ascites(P<0.05):There were no statistically significant differences in BMI,HBsAg,preoperative AFP and tumor number between the high MLR group and the low MLR group(P>0.05).There were statistically significant differences among gender,age,child-pugh grade,tumor maximum diameter,vascular invasion,performance status,cirrhosis,albumin and ascites(P<0.05).There was no statistically significant difference between the high PLR group and the low PLR group in gender,age,BMI,HBsAg,preoperative AFP,child-pugh grade,performance status,vascular invasion,tumor number,cirrhosis,albumin,and ascites(P>0.05).The maximum tumor diameter was statistically significant(P<0.05).There were no statistically significant differences in gender,age,BMI,HBsAg,child-pugh grade,performance status,vascular invasion,albumin and ascites between the high SII group and the low SII group(P>0.05).The maximum tumor size,preoperative AFP,tumor number and cirrhosis were all statistically significant(P<0.05).3.There were 138cases(67.32%)in stage ?,43 cases(20.97%)in stage?,15 cases(7.32%)in stage ?,and 9(4.39%)in stage ?.NLR is closely related to TNM staging in hepatocellular carcinoma patients,and the cut off values for stages ? to ? are 2.571,2.680,3.035 and 2.951.MLR was correlated with stage ?,?,and ? in hepatocellular carcinoma patients,and the cut off values for stages ? to ? were 0.302,0.304,and 0.328.PLR is closely related to stage ?,? and ? of hepatocellular carcinoma patients,and the cut off values of stage ? and ? are 119.62,139.62 and 135.41.SII was associated with stage ?,? and ? in patients with HCC.Thecut off values for stages ? to ? were 402.48,447.41,and 429.84.:Conclusion:1.There were differences in NLR,MLR,PLR and S?levels in peripheral blood between liver cancer patients and healthy people.Preoperative NLR,MLR,PLR and S? levels in liver cancer patients were higher than those in healthy people.2.Higher preoperative NLR,MLR,PLR and S? are closely related to the development of hepatocellular carcinoma.These markers can be used to predict the clinicopathological features of the tumor and facilitate the comprehensive preoperative evaluation of the tumor,so as to formulate a reasonable surgical approach.3.Compared with MLR,PLR and S?,NLR is a more valuable serum marker for predicting TNM staging in hepatocellular carcinoma.The higher the preoperative NLR is,the higher the tumor's TNM staging may be. |
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