Abstract
BackgroundPreoperative neutrophil-to-lymphocyte ratio (NLR) has been identified as a predictor for the recurrence of hepatocellular carcinoma (HCC), but the cut-off of NLR is inconsistent in various studies. Thus, we detected the prognostic value of preoperative NLR in the single-nodule small HCC (SHCC) patients using X-tile for cutpoint.MethodsBetween January 2007 and December 2010, a total of 222 single-nodule SHCC patients underwent curative resection and were examined for the prognostic roles of preoperative NLR by X-tile.ResultsIn this study, all patients were divided into the low-NLR subgroup (NLR ≤ 2.1) and the high-NLR subgroup (NLR > 2.1) by X-tile. Preoperative NLR showed predictive value for time to recurrence (TTR) and overall survival (OS). Moreover, NLR was associated with total bilirubin, white blood cell counts, and HBsAg, respectively (P = 0.012, <0.001, and 0.011, respectively). Especially, NLR could discriminate the outcome of patients in the subgroup with alpha-fetoprotein (AFP) levels of ≤400 ng/mL. Importantly, postoperative transcatheter arterial chemoembolization (TACE) had close relationship with OS (P = 0.001) and TTR (P ≤ 0.001).ConclusionsTherefore, this study indicates that preoperative NLR, divided by X-tile for the cutpoint, is a simple prognostic marker for the patients with single-nodule SHCC after curative resection.
Highlights
Preoperative neutrophil-to-lymphocyte ratio (NLR) has been identified as a predictor for the recurrence of hepatocellular carcinoma (HCC), but the cut-off of NLR is inconsistent in various studies
Hepatocellular carcinoma (HCC) is a typical inflammationrelated malignancy mainly induced by hepatitis B or C viral (HBV or HCV) infection and is the major challenge and cancer burden for China’s health system [1,2,3]
We clearly observed that using X-tile, high preoperative NLR could predict the poor survival of small HCC (SHCC) patients with single nodule after hepatectomy
Summary
Preoperative neutrophil-to-lymphocyte ratio (NLR) has been identified as a predictor for the recurrence of hepatocellular carcinoma (HCC), but the cut-off of NLR is inconsistent in various studies. We detected the prognostic value of preoperative NLR in the single-nodule small HCC (SHCC) patients using X-tile for cutpoint. Methods: Between January 2007 and December 2010, a total of 222 single-nodule SHCC patients underwent curative resection and were examined for the prognostic roles of preoperative NLR by X-tile. Preoperative NLR showed predictive value for time to recurrence (TTR) and overall survival (OS). Conclusions: this study indicates that preoperative NLR, divided by X-tile for the cutpoint, is a simple prognostic marker for the patients with single-nodule SHCC after curative resection. There are increasing evidences that metachronous carcinogens are affected by inflammatory activity and the malignant potential of cancer cells are the important causes of HCC recurrence [11, 12]. Accumulating evidences demonstrated that imbalance of the systemic inflammatory response orchestrated a tumorsupporting microenvironment and led to upregulation of the inflammatory process for patients with HCC [13,14,15], via some molecular pathways related with apoptosis inhibition, DNA damage repair, and angiogenesis promotion
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