Do changes in inflammatory markers predict hepatocellular carcinoma recurrence and survival after liver transplantation?

Abstract

The role of inflammation in malignant cell proliferation has been well described. High values of platelet-to-lymphocyte ratio (PLR) and neutrophil-to-lymphocyte ratio (NLR) as markers of systemic inflammation have shown associations with unfavorable long-term outcomes. The purpose of this study was to determine values of NLR and PLR evaluated prior to and after surgery and their associations with mortality and recurrence rates of liver transplant patients with hepatocellular carcinoma (HCC). Methods: A total of 105 patients with HCC who underwent orthotopic liver transplantation (OLT) were retrospectively reviewed. NLR and PLR values were obtained from complete blood counts prior to and after surgery. Overall survival (OS) and recurrence-free survival (RFS) in relation with delta NLR and PLR were estimated. Results: Serum alpha-fetoprotein levels > 100 ng/mL (p = 0.014) and lymphovascular emboli in the specimen (p = 0.048) were identified to be significant predictors of RFS. Child-Pugh score (p = 0.016) was found to be an independent factor associated with poorer OS. An increasing delta PLR was associated with worse RFS, although it showed no significant association with OS. Conclusions: The analysis of PLR as a continuous variable may predict recurrence outcomes in patients undergoing OLT for HCC. It is more representative than isolated values.

Development of preoperative and postoperative machine learning models to predict the recurrence of huge hepatocellular carcinoma following surgical resection

“…According to VIMP analysis, PNLR and PLR were two important risk factors for the recurrence of huge HCC. According to previous studies, PNLR or PLR can be used as clinical indicators of the host inflammatory response and immune status, while an increasing PNLR or PLR is a strong predictor of poor survival in certain types of malignancies (47)(48)(49)(50). It has been reported that a higher PNLR and PLR were correlated with a poorer prognosis among patients with HCC (48).…”

Inflammation-related prognostic markers in resected hepatocellular carcinoma

“…In the last years several authors reported a strong correlation between systemic inflammation and HCC prognosis with different systemic and pathological markers associated with survival and recurrence. For example, high values of platelet-tolymphocyte ratio (PLR), neutrophil-to-lymphocyte ratio (NLR) and other similar scores seem to predict poor long-term outcomes after treatment (9)(10)(11). This relationship is also evident on a molecular level as gene expression alterations are at the basis of these inflammatory cell shifts on which cancer develops and progresses (12).…”