Preoperative Neutrophil-to-Lymphocyte Predicts Prognostic Outcome Of Hepatectomy For Hepatocellular Carcinoma Of BCLC A-C Astge

Objective To evaluate Preoperative neutrophil-to-lymphocyte ration(NLR)predicts prognostic outcome of hepatectomy for hepatocellular carcinoma(HCC)of BCLC A-C stage.Methods Clinical and pathological data 111 of HCC ptients who underwent hepatectomy where the Department of Hepatobiliary Surgery of General Hospital of Ningxia Medical University was collected in November,2009 to November,2014.Receiver operating characteristics curve(ROC)found that optimal of NLR was 2.04.The patients were divided into NLR≥2.04 and NLR<2.04 group.Then the HCC patients of Barcelon Clinic Liver Cancer(BCLC)would be further stratified analysis.Cox regression model was used to be analysis of univariate and multivariate for prognostic factors.Kaplan-Meier method calculated disease free survival(DFS)and overall survival(OS).Results NLR≥2.04 and NLR<2.04 group is no significant difference among clinical and pathological factors.DFS,OS of 111 HCC patients was 52.25%,27.93%,25.23%,81.98%,60.36%,49.55% in 1,3,5 years respectively.The relation of NLR and severity of cirrhhosis was significant,but the correlation analysis was no obvious difference.There was no difference between NLR and portal hypertension.Univariate analysis indicated that the patients of NLR≥2.04,ascites was inferior to AFP<400ng/ml,NLR<2.04,no ascites for DFS.The patients of NLR<2.04,AFP<400ng/ml,TBIL≤17.1umol/L was superior to NLR≥2.04,AFP≥400ng/ ml,TBIL>17.1umol/L with regard to OS.The degree of differentiation and different BCLC st-age were all different for OS.Multivariate analysis revealed that NLR was independent risk factor of the recurrence.The patients of NLR<2.04 were longer than NLR≥2.04 about DFS.NLR,TBIL,and differentiated degree were independent risk factor of the death.NLR<2.04 and TBIL≤17.1umol/L were longer than the patients patients of NLR≥2.04,TBIL>17.1umol/L for OS.The patients of high differentiation and moderatedly differentiated were superior to poorly differentiated about OS.The patients of high differentiation and moderatedly differentiated were no significant difference.The stratified analysis indicated that BCLC A stage of NLR<2.04 was no different than the patients of NLR≥2.04 for DFS,but OS is diverse.The BCLC B stage of NLR<2.04 group was no significant difference to NLR≥2.04 group for DFS and OS.The BCLC C stage of NLR<2.04 group was significant difference to NLR≥2.04 group about DFS.BCLC C stage of NLR<2.04 group was superior to NLR≥2.04 group about DFS and OS.Conclusions Optimal of NLR was 2.04.NLR≥2.04 group was inferior that NLR<2.04 group underwent hepatectomy of HCC for DFS and OS.NLR can serve as predicting prognostic index that underwent hepatectomy of HCC.NLR,TBIL,BCLC stage and differentiated degree were independent risk factor of prognosis undergoing hepatectomy of HCC.NLR was influenced by severity of cirrhosis,but in addition to portal hypertension.