Preoperative Neutrophil‐to‐Lymphocyte Ratio as a Prognostic Predictor after Curative Resection for Hepatocellular Carcinoma

Abstract

Preoperative NLR >or= 5 was an adverse predictor of disease-free and overall survival.

The Multifaceted Roles Neutrophils Play in the Tumor Microenvironment

“…From then on, a large number of clinical studies have been performed to understand the neutrophil-cancer relationship. Clinical data have often related elevated circulating neutrophil counts or elevated neutrophil-to-lymphocyte ratios (NLRs) as a predictive parameter for poor outcome and formation of distant metastasis in patients with epithelial malignancies [367], including lung [368,170], gastric [159,163,369], renal cell carcinoma [370], ovarian [141], hepatic [143,148,371], pancreatic [138], colon cancer [145,372], and colorectal carcinoma [152] (Table 3). However, Caruso et al [200] observed that when analyzing the amount of tumor-infiltrated neutrophils in advanced gastric carcinoma, in female but not male, patients with higher TANs had a favorable prognosis.…”

“…[148] Hepatocellular carcinoma (HCC) Patients with an NLR>2.5 showed higher risk for tumor recurrence in HCC patients undergoing liver transplantation.…”

A new prognostic scoring system using factors available preoperatively to predict survival after operative resection of perihilar cholangiocarcinoma

“…Recently, several reports have indicated that the state of the Systemic Inflammatory Response (SIR) provides significant information about the prognoses of a variety of cancers [19][20][21][22][23][24][25][26][27][28][29][30][31][32][33] . Neutrophil-lymphocyte ratio (NLR), which reflects SIR, has been reported as a prognostic factor in gastrointestinal cancers, including intrahepatic cholangiocarcinoma 19 and colorectal cancer 20 .…”

Elevated preoperative neutrophil : lymphocyte ratio as a preoperative indicator of mature cystic teratoma with malignant transformation

“…The N/L ratio was calculated from the differential count by dividing the absolute neutrophil count by the absolute lymphocyte count. An N/L ratio ≥5 was considered elevated in accordance with the literature 8, 11, 17, 18…”

“…The tumor cells then produce chemokines, cytokines, and prostaglandins, which recruit inflammatory cells, which then subsequently trigger cancer‐related inflammation and further facilitate various tumor‐promoting effects 7. The neutrophil : lymphocyte (N/L) ratio has been shown to reflect the immune response and has been identified as a prognostic marker in many cancers, including gastrointestinal tract malignancy, non‐small cell lung cancer, cervical cancer, hepatocellular carcinoma, pancreatic cancer, ovarian cancer, and soft‐tissue sarcoma, reflecting a consistently decreased survival in patients with a high N/L ratio 8, 9, 10, 11, 12, 13, 14, 15. In addition, N/L ratio is reportedly correlated to incidental microcarcinoma in thyroid goiters, further indicating its potential as a diagnostic marker 16.…”