Value of neutrophil-to-lymphocyte ratio in the diagnosis and prognosis evaluation of primary hepatocellular carcinoma

Objective To investigate the value of neutrophil-to-lymphocyte ratio (NLR) in the diagnosis and prognosis evaluation of primary hepatocellular carcinoma. Methods The clinical data of 100 patients pathologically diagnosed as primary liver cancer who were admitted to the First Medical Center of Chinese PLA General Hospital from January 2013 to December 2015 were retrospectively analyzed. Serum alpha fetoprotein (AFP), a conventional marker for hepatocellular carcinoma diagnosis was used as the control. The fourfold table diagnostic test was applied to analyze the sensitivity and specificity of serum NLR in the diagnosis of hepatocellular carcinoma, and the correlation with the degree of tumor differentiation was also analyzed. Results The proportion of patients with high NLR (≥1.70) [56% (56/100)] was higher than the proportion of patients with positive AFP [44% (44/100)] in all 100 hepatocellular carcinoma patients, but the difference was not statistically significant (χ2 = 2.88, P = 0.08). Among AFP-positive patients, the median survival time of patients with low and high NLR was 59 and 48 months, respectively, and the difference was statistically significant (χ2 = 3.91, P = 0.048), and high NLR was an independent risk factor affecting the prognosis of hepatocellular carcinoma patients (HR = 1.232, 95% CI 1.055-1.438, P = 0.008). Conclusions The detection of NLR combined with AFP can improve the diagnostic rate of hepatocellular carcinoma before surgery. High NLR is an independent risk factor affecting the prognosis of patients with primary hepatocellular carcinoma. Key words: Liver neoplasms; Neutrophil-to-lymphocyte ratio; Diagnosis; Prognosis