Aspartate Aminotransferase to Platelet Ratio Index Versus Neutrophil to Lymphocyte Ratio for Prediction of Post Radiofrequency Ablation Recurrence of Hepatocellular Carcinoma.

Abstract

Background & Aims:Tumor recurrence after curative radiofrequency ablation (RFA) of hepatocellular carcinoma (HCC) is common. The burden of frequent post-ablation investigations especially triphasic computerized tomography (TCT) is high. We investigated whether post ablation measurement of aspartate aminotransferase to platelet ratio index (APRI) and neutrophil to lymphocyte ratio (NLR) as simple and cheap biomarkers can precisely predict HCC recurrence and which of them is more valuable. Methods: In this retrospective study, the demographic, clinical, laboratory and imaging data of 42 HCC patients treated with RFA were statistically analyzed. Patients were classified into two groups; those with HCC recurrence (group I) and those without (group II). In order to test the value of baseline NLR versus that of APRI in predicting tumor recurrence and compare both to alfa fetoprotein (AFP), we used receiver operating curve (ROC) statistics. Results: Mean values of AST, Platelets count, APRI, NLR and AFP showed significant correlation with HCC recurrence. Using logistic regression analysis, NLR was the only independent risk factor predicting HCC recurrence. NLR had the highest sensitivity and specificity for prediction of HCC recurrence (90.9 % and 85%) followed by that of AFP (86.4 % and 75%), and lastly by that of APRI (72.7% and 70%). Conclusion: NLR is a promising, simple and cheap surrogate marker for prediction of HCC recurrence after radiofrequency ablation, and is far more significant than APRI. .