The Clinical Value Of NLR In Predicting Recurrence Of Primary Liver Cancer Patients After Microwave Ablation

Objective:To explore the predictive value of preoperative and postoperative neutrophil/lymphocyte ratio(NLR)and preoperative and postoperativeneutrophil/lymphocyte ratio(PP-NLR)in recurrence of primary liver cancer afterMicrowave ablation,MWA),and to provide reference for guiding clinical treatment of primary liver cancer in the future.Methods:The clinical data of 78 patients with PLC treated by microwave ablation(MWA)in the Affiliated Hospital of Yanbian University from January 2016 to September 2020 were retrospectively analyzed,including 55 males and 23 females,with an average age of 63.99±7.93 years.The results of peripheral blood routine were collected one month before and one month after operation,and NLR was calculated before and after operation.The best cut-off value was determined by drawing receiver operating characteristic(ROC)curve,and the progression free survival rate was compared after grouping.Kaplan Meier method was used to draw survival curve and analyze.Univariate and multivariate Cox regression analysis was used to analyze the relationship between each factor and progression free survival.In this study,PLC patients were followed up for 0.87-52 months.Results:1.The 78 patients median progression-free survival time was 9.935 months(5.23-13.46 months).During the follow-up period,43 patients did not recur until the end of the follow-up time,while 35 patients recurred(including 5 deaths),with a recurrence rate of 44.9%and a complete ablation rate of 88.5%.2.According to the clinical data of 78 patients with primary liver cancer after MWA treatment,the ROC curve was drawn,and the optimal critical values of NLR before and after operation were 1.852 and 2.190,respectively,and the area under ROC curve was 0.715 and 0.740.3.According to the optimal critical value,the preoperative NLR and postoperative NLR were divided into two groups,with a low NLR score of 0 and a high NLR score of 1.NLR before operation+NLR after operation(PP-NLR)=0/1/2.4.The recurrence rate of PP-NLR(0)group was 0.5%,PP-NLR(1)group was37.5%,PP-NLR(2)group was 68.6%.5.Univariate analysis showed that there was no statistical difference in clinical data such as gender,age,nationality,tumor size,number of lesions and AFP(P>0.05).Postoperative neutrophils(x~2=10.152,P<0.01),postoperative lymphocytes(x~2=4.719,P<0.05),preoperative NLR(x~2=12.276,P<0.01),postoperative NLR(x~2=10.852,P<0.01)and CNLC stage(x~2=4.418,P<0.05)are the influencing factors of progression-free survival time of PLC patients after MWA treatment,with statistical differences(all P<0.05).6.Incorporating the above-mentioned related factors into multivariate COX regression,the results show that only PP-NLR group is an independent risk factor for PLC patients to survive without progress after MWA treatment,that is,high NLR before operation and high NLR after operation are independent risk factors for recurrence of PLC patients after MWA treatment.Conclusion:1.Preoperative NLR,postoperative NLR,postoperative neutrophils,postoperative lymphocytes,CNLC stage and PP-NLR can be the influencing factors of PLC patients’progression-free survival.2.PP-NLR is more effective than other influencing factors in predicting progression-free survival,and PP-NLR is an independent risk factor for recurrence of PLC patients after MWA treatment.3.Blood routine has a certain clinical value in the prognosis evaluation of primary liver cancer after microwave ablation.