Ann Surg Treat Res.  2022 Aug;103(2):72-80. 10.4174/astr.2022.103.2.72.

Preoperative lymphocyte-to-C-reactive protein ratio predicts hepatocellular carcinoma recurrence after surgery

• Utsumi M
• Inagaki M
• Kitada K
• Tokunaga N
• Kondo M
• Sakurai Y
• Yunoki K
• Hamano R
• Miyasou H
• Tsunemitsu Y
• Otsuka S

• KMID: 2532361
• DOI: http://doi.org/10.4174/astr.2022.103.2.72

Abstract

Purpose
This study was performed to determine the prognostic value of lymphocyte-to-CRP ratio after curative resection for hepatocellular carcinoma.
Methods
Between July 2010 and October 2021, 173 consecutive patients (144 male, 29 female) who underwent surgical resection for pathologically confirmed hepatocellular carcinoma were included in this retrospective study. Cox regression analysis was used to evaluate the relationship between clinicopathological characteristics and recurrence-free survival (RFS) and overall survival (OS). A P-value of <0.05 was considered statistically significant.
Results
The patients (mean age, 71 years) were stratified into high (≥9,500, n = 108) and low (<9,500, n = 65) lymphocyteto-CRP ratio groups. The low lymphocyte-to-CRP ratio group had significantly worse RFS and OS. Low lymphocyte-toCRP ratio (hazard ratio [HR], 1.865; 95% confidence interval [CI], 1.176–2.960; P = 0.008), multiple tumors (HR, 3.333; 95% CI, 2.042–5.343; P < 0.001), and microvascular invasion (HR, 1.934; 95% CI, 1.178–3.184; P = 0.009) were independently associated with RFS, whereas low albumin-to-globulin ratio (HR, 2.270; 95% CI, 1.074–4.868; P = 0.032), α-FP of ≥25 ng/mL (HR, 2.187; 95% CI, 1.115–4.259; P = 0.023), and poor tumor differentiation (HR, 2.781; 95% CI, 1.041–6.692; P = 0.042) were independently associated with OS. Lymphocyte-to-CRP ratio had a higher area under the curve (0.635) than other inflammation-based markers (0.51–0.63).
Conclusion
Lymphocyte-to-CRP ratio is superior to other inflammation-based markers as a predictor of RFS in patients with surgically resected hepatocellular carcinoma.

Keyword

Biomarkers; Hepatocellular carcinoma; Prognosis; Regression analysis; Survival

Figure

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  Fig. 1 Receiver operating characteristic curve determining the optimal cutoff value of the lymphocyte-to-CRP for predicting recurrence-free survival after surgery in patients with hepatocellular carcinoma.

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  Fig. 2 Kaplan-Meier curves of (A) recurrence-free survival (RFS) and (B) overall survival (OS) in the high and low lymphocyte-to-CRP ratio (LCR) groups. The high (≥9,500) and low (<9,500) LCR groups are represented by solid and dashed lines, respectively.

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