Does Neutrophil to Lymphocyte Ratio Have a Role in Identifying Cytokeratin 19-Expressing Hepatocellular Carcinoma?

Abstract

Background: Cytokeratin 19-positive (CK19(+)) hepatocellular carcinomas (HCC) are generally associated with poor prognosis after hepatectomy. It is typically detected from postoperative immunochemistry. We have analyzed several clinically available biomarkers, in particular, neutrophil to lymphocyte ratio (NLR) and aim to develop a panel of biomarkers in identifying CK19 expression in (HCC) preoperatively. Methods: We retrospectively reviewed 36 HCC patients who underwent liver resections during January 2017 to March 2018 in Chang Gung Memorial Hospital. Patients were grouped based on the status of CK19 expression and their baseline characteristics, perioperative and oncologic outcomes were compared. Novel biomarkers including NLR, alpha-fetoprotein (AFP), carcinoembryonic antigen (CEA) and uric acid were analyzed and correlated with CK19 expression. Results: NLR is highly associated with CK19 expression. NLR alone gave an AUROC of 0.728 (p-value = 0.043), higher than AFP, CEA or tumor size alone. NLR when combined with AFP, CEA and uric acid, gave an AUROC as high as 0.933 (p-value = 0.004). Conclusion: The current study demonstrated the predictive capability of NLR in combination with AFP, CEA and uric acid for CK19 expression in HCC patients preoperatively. Further prospective, large-scale studies are warranted to validate our findings.

Prediction Model and Nomogram of Early Recurrence of Hepatocellular Carcinoma after Radiofrequency Ablation Based on Logistic Regression Analysis

“…This proves that there is indeed a link between increased NLR and early relapse. Many studies (Chen et al 2021;Lee et al 2021) have used NLR alone as a risk factor. Our research links NLR with other elements in the construction of the model, which makes our model more comprehensive and valuable.…”

“…While some previous studies have examined the relationship between alpha-fetoprotein and the early recurrence of HCC, some only examined the relationship between contrast-enhanced ultrasound (CEUS) parameters and the early recurrence of HCC, and others analyzed only the relationship between inflammatory markers and the early recurrence of HCC, such as the neutrophil-to-lymphocyte ratio (NLR) (Han et al 2020;Hermida et al 2020;Lee et al 2021). a-Fetoprotein level is the most commonly used and crucial serum marker for diagnosing liver cancer and predicting recurrence.…”