Yunpeng Hua,Fei Ji,Shunjun Fu,Shunli Shen,Shaoqiang Li,Lijian Liang,Baogang Peng. The preoperative neutrophil-to-lymphocyte ratio predicts the outcomes of patients with hepatocellular carcinoma and cirrhosis after hepatectomy. Oncol Transl Med, 2015, 1: 249-255.
The preoperative neutrophil-to-lymphocyte ratio predicts the outcomes of patients with hepatocellular carcinoma and cirrhosis after hepatectomy
Received:September 01, 2015  Revised:November 24, 2015
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KeyWord:hepatocellular cancer (HCC); neutrophil-to-lymphocyte ratio (NLR); pathology; prognosis
Author NameAffiliationE-mail
Yunpeng Hua Department of Hepatic Surgery, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510080, China hyp0427@163.com 
Fei Ji Department of Organ Transplant Center,The First Affiliated Hospital of Sun Yat-sen University,Guangzhou 510080, China hyp0427@163.com 
Shunjun Fu Department of Organ Transplant Center,The First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510080, China hyp0427@163.com 
Shunli Shen Department of Hepatic Surgery, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510080, China hyp0427@163.com 
Shaoqiang Li Department of Hepatic Surgery,The First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510080, China hyp0427@163.com 
Lijian Liang Department of Hepatic Surgery, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510080, China hyp0427@163.com 
Baogang Peng Department of hepatic Surgery, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510080, China pengbaogang@medmail.com.cn 
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Abstract:
      Objective: The aim of the study was to investigate the prognostic value of the preoperative peripheral neutrophil-to-lymphocyte ratio (NLR) in patients with hepatocellular cancer (HCC) and cirrhosis after hepatectomy. Methods: This retrospective study included 321 patients with HCC who underwent resection. The NLR was calculated using the neutrophil and lymphocyte counts in routine preoperative blood tests. Receiver operating characteristic curve analysis was performed to select the most appropriate NLR cutoff value. The preoperative NLR, patient demographics, and clinical and pathological data, including disease-free survival (DFS) and overall survival (OS), were analyzed. Results: The NLR was correlated with alpha-fetoprotein levels (χ2 = 5.876, P = 0.015), tumor size (χ2 = 32.046, P < 0.001), portal vein tumor thrombus (PVTT; χ2 = 4.930, P = 0.026), tumor encapsulation (χ2 = 7.243, P = 0.007), and recurrence (χ2 = 7.717, P = 0.005). Multivariate analyses illustrated that the number of tumors, PVTT, tumor size, and the NLR were independent factors for predicting DFS and OS. In patients with HCC and cirrhosis, but not among those without cirrhosis, a larger NLR predicted poorer postoperative DFS and OS (both P < 0.001). Conclusion: As a simple, effective independent predictor for patients with HCC, the preoperative NLR plays an important role in accurately predicting the postoperative outcomes of patients with HCC and cirrhosis, but not those of patients without cirrhosis.
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