The Value Of White Blood Cell-associated Indicators In The Prognosis Of Unresectable Hepatocellular Carcinoma

Background:White blood cell-associated indicators can be used as prognostic markers in cancer cases.The present study investigated the potential value of white blood cell,lymphocyte,monocyte,neutrophil,eosinophil and neutrophil-to-lymphocyte ratio in the prognosis of unresectable hepatocellular carcinoma.Methods:This retrospective study recruited 101 unresectable hepatocellular carcinoma cases which were pathologically confirmed.The patients were divided into two groups according to the median values of white blood cell,lymphocyte,monocyte,neutrophil,eosinophil and neutrophil-to-lymphocyte ratio.The post/pre-chemotherapeutic ratios were defined as the rate of pre-chemotherapeutic white blood cell-associated indicators values and the corresponding ones obtained after chemotherapy.Kaplan-Meier curves were constructed to show overall survival.The associations between white blood cell-associated indicators and chemotherapeutic efficacy were explored and assessed by the Chi-square tests.Multivariate logistic regression model was employed to identify the independent risk factors.The receiver operating characteristic analysis was performed to evaluate the predictive value of white blood cell-associated indicators for unresectable hepatocellular carcinoma.Results:Baseline white blood cell count,monocyte count,neutrophil count and neutrophil-to-lymphocyte ratio were negatively related to overall survival.Lower baseline eosinophil count was related to better chemotherapeutic efficacy.Changes in lymphocyte,white blood cell,monocyte,neutrophil,eosinophil levels and neutrophil-to-lymphocyte ratio after chemotherapy were not correlated to the outcomes of hepatocellular carcinoma patients.Univariate analysis indicated that gender(woman),higher baseline neutrophil count,higher baseline white blood cell count and higher neutrophil-to-lymphocyte ratio were prognostic factors affecting overall survival.Multivariate Cox regression analysis revealed that gender(woman)and higher neutrophil-to-lymphocyte ratio were independently prognostic factors affecting overall survival.Receiver operating characteristic curve analysis showed baseline white blood cell count,neutrophil count and neutrophil-to-lymphocyte ratio could predict unresectable hepatocellular carcinoma.Conclusions:White blood cell count,monocyte count,neutrophil count,and neutrophil-to-lymphocyte ratio are associated with overall survival of unresectable hepatocellular carcinoma patients and neutrophil-to-lymphocyte ratio may be a significant potential prognostic factor.