Abstract
IntroductionSeveral markers of systemic inflammation, including blood C-reactive protein, platelet lymphocyte ratio (PLR) and neutrophil lymphocyte ratio (NLR) have been identified as independent prognosticators for hepatocellular carcinoma (HCC).MethodsTo attempt to understand the significance of these markers, they were examined in relation to 4 tumour parameters, namely maximum tumour diameter (MTD), tumour multifocality, portal vein thrombosis (PVT) and blood alpha-fetoprotein (AFP) levels.ResultsUsing linear and logistic regression models, we found that C-reactive protein and PLR on single variables, were statistically significantly related to the tumour parameters. In a logistic regression final model, CRP was significantly related to MTD, AFP and PVT, and the Glasgow Index significantly related to MTD and AFP. Results of the area under the receiver operating characteristic curves (ROC), showed that the areas for PLR and CRP were statistically significant for high versus low MTD and for presence versus absence of PVT. CRP alone was significant for high versus low AFP.ConclusionsThese analyses suggest that the prognostic usefulness of the inflammatory markers PLR and CRP (but not NLR) may be due to their reflection of parameter values for tumour growth and invasiveness.
Highlights
Several markers of systemic inflammation, including blood C-reactive protein, platelet lymphocyte ratio (PLR) and neutrophil lymphocyte ratio (NLR) have been identified as independent prognosticators for hepatocellular carcinoma (HCC)
We compare in a large Turkish HCC cohort, the neutrophil-to-lymphocyte ratio, the platelet-to-lymphocyte ratio and the C-reactive protein values and examine the relationship of all 3 indices to parameters of HCC tumour aggressiveness, in an attempt to explain the prognostic usefulness of these inflammatory indices
We found that the PLR ratio and the C-reactive protein (CRP) levels were significantly greater in the patients with presence of portal vein thrombosis (PVT) compared with the PVT absent group (p = 0.034 and p
Summary
Several markers of systemic inflammation, including blood C-reactive protein, platelet lymphocyte ratio (PLR) and neutrophil lymphocyte ratio (NLR) have been identified as independent prognosticators for hepatocellular carcinoma (HCC). The Glasgow inflammation score consisting of CRP and albumin, and has been shown to be an independent prognosticator for several cancer types, including HCC [817]. We compare in a large Turkish HCC cohort, the neutrophil-to-lymphocyte ratio, the platelet-to-lymphocyte ratio and the C-reactive protein values (part of the Glasgow Index) and examine the relationship of all 3 indices to parameters of HCC tumour aggressiveness, in an attempt to explain the prognostic usefulness of these inflammatory indices
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