Preoperative lymphocyte-to-C-reactive protein ratio predicts hepatocellular carcinoma recurrence after surgery. 2022

Masashi Utsumi, and Masaru Inagaki, and Koji Kitada, and Naoyuki Tokunaga, and Midori Kondo, and Yuya Sakurai, and Kosuke Yunoki, and Ryosuke Hamano, and Hideaki Miyasou, and Yousuke Tsunemitsu, and Shinya Otsuka
Department of Surgery, National Hospital Organization Fukuyama Medical Center, Fukuyama, Japan.

This study was performed to determine the prognostic value of lymphocyte-to-CRP ratio after curative resection for hepatocellular carcinoma. 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. The patients (mean age, 71 years) were stratified into high (≥9,500, n = 108) and low (<9,500, n = 65) lymphocyte-to-CRP ratio groups. The low lymphocyte-to-CRP ratio group had significantly worse RFS and OS. Low lymphocyte-to-CRP 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). Lymphocyte-to-CRP ratio is superior to other inflammation-based markers as a predictor of RFS in patients with surgically resected hepatocellular carcinoma.

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