Prognostic value of preoperative inflammatory markers in patients with hepatocellular carcinoma who underwent curative resection

Abstract

Background The prognosis of hepatocellular carcinoma (HCC) is not optimistic. Our study focused on present inflammatory markers, including the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), gamma-glutamyl transpeptidase-to-platelet ratio (GPR), aspartate aminotransferase-to-lymphocyte ratio (ALR) and fibrinogen-to-albumin ratio (FAR), and explored their optimal combination for the prognosis of HCC after resection. Methods A total of 347 HCC patients who underwent curative resection were enrolled. The optimal cutoff values of the inflammatory markers were calculated using receiver operating characteristic (ROC) curve analysis, and used to divide patients into two groups whose differences were compared by Kaplan–Meier analysis. Cox univariate and multivariate analyses were used to analyze the independent prognostic inflammatory markers. The χ2 test was chosen to determine the relationship between independent prognostic inflammatory markers and clinicopathological features. We created combined scoring models and evaluated them by Cox univariate and multivariate methods. The concordance index (C-index), Akaike information criterion (AIC) and likelihood ratio were calculated to compare the models. The selected optimal inflammatory markers and their combinations were tested in different stages of HCC by Kaplan–Meier analysis. Results The ALR and GPR were independent prognostic factors for disease-free survival (DFS); the ALR, PLR, and GPR were independent prognostic factors for overall survival (OS). The proposed GPR and ALR-GPR-PLR score models were independent predictors for DFS and OS, respectively. Conclusion The preoperative GPR and ALR-GPR-PLR score models were independent predictors for DFS and OS, respectively, and performed well in stratifying patients with HCC. The higher the score in the model was, the worse the prognosis.

Serum gamma-glutamyl transpeptidase-to-platelet ratio (GPR) can predict the prognosis of hepatocellular carcinoma: a meta-analysis and systematic review

“…Among the 865 articles identified, 45 articles were screened out after full-text screening. Of these, 7 studies ( 3 , 12 - 17 ) involving 1,952 patients met inclusion criteria. No articles were added after evaluating the reference lists.…”

Effect of Tertiary Lymphoid Structures on Prognosis of Patients with Hepatocellular Carcinoma and Preliminary Exploration of Its Formation Mechanism

“…According to our results, LCK expression is positively correlated with the number of neutrophils, and increased expression of LCK promotes the aggregation of neutrophils in the TME. Neutrophils, however, are associated with a worse prognosis in HCC patients and are resistant to anti-tumour immunotherapy in HCC patients [ 51 , 52 ]. This contradictory phenomenon does not negate the protective effects of LCK in HCC.…”

A Nomogram Based on Hematological Parameters and Clinicopathological Characteristics for Predicting Local–Regional Recurrence After Breast-Conserving Therapy

“…Inflammation can promote the proliferation of cells in new plasma, stimulate angiogenesis, and reduce immunity, thereby promoting cancer recurrence and progression (19). Many studies have shown that the indicators of NLR, MLR, and PLR changed significantly in the recurrence or metastasis of breast cancer, liver cancer, and small cell lung cancer (36)(37)(38). In this study, NLR was significantly correlated with LRR as an independent factor, while MLR and PLR did not show significant correlation with LRR in multivariate analysis of LRR.…”