Neutrophil Lymphocyte Ratio to Albumin Ratio and White Blood Cell to Hemoglobin Ratio as Prognostic Markers for Hepatocellular Carcinoma Patients Who Underwent Curative Hepatectomy

Abstract

Purpose Inflammation factors affect the prognosis of hepatocellular carcinoma (HCC). However, it is not clear if the preoperative neutrophil lymphocyte ratio to albumin ratio (NLRAR) and white blood cell to hemoglobin ratio (WHR) affect the prognosis of HCC post curative hepatectomy. We assessed the prognostic values of NLRAR and WHR in patients suffering from HCC who underwent curative resection. Materials and Methods A total of 169 eligible HCC cases were reviewed. The optimal cut-off values for NLRAR and WHR were selected using the X-tile software. The overall survival (OS) rate was assessed following the Kaplan–Meier analysis method. The Log rank test and Cox proportional hazard regression model were also used to analyze the data. The prognostic values of NLRAR and WHR were calculated by analyzing the area under the receiver operating characteristic curve (AUC). The decision curve analysis (DCA) was performed for clinical benefits. Results The OS rate recorded for the high NLRAR group was poorer than the OS rate recorded for the low NLRAR group. Similar trends were observed for WHR. The NLRAR and WHR were the independent predictors of OS. The results were based on the multivariate Cox analyses method. Results obtained by analyzing the subgroups revealed that NLRAR and WHR could be used for the prognosis of HCC in tumor stage I-patients. The NLRAR–WHR scoring system (NWS) could be used to classify HCC patients into two cohorts with different prognoses. This scoring system was more efficient than NLRAR or WHR in predicting OS. Conclusion The preoperative NLRAR and WHR are effective prognostic indicators for HCC in patients who underwent curative hepatectomy.

Association between white blood cell‐to‐haemoglobin ratio and 30 day mortality in heart failure in intensive care unit

“…WHR was a combined index of WBC and HGB and has been reported to be associated with the mortality in patients with gastric adenocarcinoma or hepatocellular carcinoma 10,11 . In this study, we found that high WHR was associated with high risk of 30 day mortality in HF patients admitted to the ICU.…”

“…WHR was a combined index of WBC and HGB and has been reported to be associated with the mortality in patients with gastric adenocarcinoma or hepatocellular carcinoma. 10,11 In this study, we found that high WHR was associated with high risk of 30 day mortality in HF patients admitted to the ICU. For HF patients, systemic inflammation was recognized as a common pathological and biological feature, which was linked to the disease progression and complication, and predicted the poor outcomes.…”

“… 9 Considering this, it is necessary to explore the impact of anaemia and inflammation on the prognosis of HF patients. White blood cell‐to‐haemoglobin ratio (WHR) has been used to predict the survival of patients with gastric adenocarcinoma or hepatocellular carcinoma, 10 , 11 while the association between WHR and the risk of mortality in HF patients admitted to the ICU has not been reported.…”

Serum Inflammation Parameters and Survival in Hepatocellular Carcinoma Patients: Importance of Albumin and Gamma-Glutamyltranspeptidase

“…Many effector chemokines and cytokines have been described as being involved, resulting in an enhancement of tumor growth and invasiveness. Among its several physiological functions in the blood, serum albumin levels have been well-described as an inflammation marker and a prognostic marker in HCC [18][19][20][21][22][23][24][25][26][27][28][29][30][31] and albumin may actively participate in HCC growth control mechanisms [12,13,28,32], possibly through its ability to bind reactive oxygen species and so modulate inflammation [33,34].…”

Prognostic value of preoperative white blood cell to hemoglobin ratio and fibrinogen to albumin ratio in patients with colorectal cancer

“…[8,9] Recently it has been shown that preoperative white blood cells to hemoglobin ratio (WHR) are related to poor prognosis in patients with hepatocellular carcinoma after hepatectomy. [10] Meanwhile, preoperative fibrinogen to albumin ratio (FAR) has been shown to be associated with poor prognosis in a variety of cancers. [11][12][13][14] However, the effects of preoperative white blood cell to hemoglobin ratio (WHR) and fibrinogen to albumin ratio (FAR) on CRC patients have not been fully elucidated.…”