Correlation Analysis Between Postoperative Liver Failure And Platelet Count,NLR And PLR In Patients With Liver Cancer At Plateau Area

Objective: To explore the NLR,PLR,PLT for primary hepatocellular carcinoma(HCC)in patients with liver postoperative liver failure(PHLF)correlation and prediction value.Methods: Qinghai university affiliated hospital liver surgery were retrospectively analyzed in January 2015-January 2022 by parallel of surgical treatment for patients with primary hepatocellular carcinoma(HCC)in the hospital.And collect the patients’ clinical information: the patient’s gender,age,height,weight,whether infection in chronic hepatitis B viral hepatitis,Child-Pugh classification;Preoperative admission first laboratory examination indexes: International standardization Ratio(INR),Fibrinogen(FIB),Prothrombin time(PT),Albumin(ALB),Total Bilirubin(TB),Alanine aminotransferase(ALT),Aspartate transaminase(AST),Alkaline phosphatase(ALP),Neutrophils and Lymphocytes Ratio(NLR),White Blood Cells(WBC),The platelet count(PLT),Platelet and Lymphocyte Ratio(PLR),Neutrophil(NE),Lymphocyte(LYM);The postoperative test data include: TB and INR on postoperative day 5.The operation information includes: perioperative blood loss;Pathological data including: TNM staging of liver cancer.According to International Study Group of Liver Surgery(ISGLS)standard to judge whether PHLF and grouping.The basic data of patients compared between those groups.The area under the curve was obtained by constructing the ROC curve,and then comparing the predicted value of PLT,NLR,and PLR for PHLF.Group according to the optimal cut-off value to obtain the relationship between different groups and the occurrence of postoperative liver failure.Finally,Logistic regression was used to construct the joint index of PLT,NLR and PLR.To complete its prediction of postoperative liver failure.Results:The statistically significant factors in univariate analysis were ALB,lym,INR,Pt,TB,intraoperative blood loss,PLT,NLR,PLR,Child-pugh classification and TNM stageof liver cancer;TNM stage,intraoperative blood loss and NLR were independent risk factors of PHLF in patients with liver cancer after hepatectomy;NLR and PLR were positively correlated with postoperative PHLF in HCC patients,and PLT was negatively correlated with it;the PHLF rate in the low PLT group was higher than that in the high group,with statistical significance(P<0.05),and the PHLF rate in the high NLR group and the high PLR group were higher than the lower group,with statistical significance(P<0.05).And build the joint indicators:-0.891-0.031×PLT+0.292×NLR+0.028×PLR,For the predictive value of PHLF,the AUC of the combined indicators,NLR,PLT and PLR are 0.840,0.731,0.644 and 0.642,respectively.Conclusion: In this study,it was concluded that the postoperative occurrence of PHLF in patients with HCC was associated with PLT,NLR and PLR.The occurrence of PHLF is inversely correlated with PLT,and PHLF is easy to occur when the patient PLT is in a low state;it is positively correlated with NLR and PLR,and as the value of NLR and PLR increases,the PHLF rate of patients gradually increases;NLR,PLR,and PLT all have predictive value for whether PHLF occurs in patients with HCC,contrasting the three indicators NLR has a high predictive value for the PHLF,However,using the combination index can predict the patient PHLF more accurately.