Prognostic Impact of Lymphocyte–C-Reactive Protein Ratio in Patients Who Underwent Surgical Resection for Hepatocellular Carcinoma

Yugawa, Kyohei; Maeda, Takashi; Kinjo, Nao; Kawata, Koto; Ikeda, Sei; Edahiro, Keitaro; Edagawa, Makoto; Omine, Takahiro; Kometani, Takuro; Yamaguchi, Shohei; Konishi, Kozo; Tsutsui, Shinichi; Matsuda, Hiroyuki

doi:10.1007/s11605-021-05085-z

Cited by 18 publications

(13 citation statements)

References 28 publications

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“…29 , 30 For this reason, low PreLCR has been associated with poor immunological response, malnutrition, and/or enhancement of systemic inflammatory response in cancer patients, and it is a convenient prognostic marker for patients with HCC. 14 , 15 , 31 …”

Section: Discussionmentioning

confidence: 99%

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Combining Pre- and Postoperative Lymphocyte–C-Reactive Protein Ratios Can Better Predict Hepatocellular Carcinoma Prognosis After Partial Hepatectomy

Ni¹,

Zhan²,

Huang³

et al. 2022

JIR

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Background Various preoperative inflammatory indicators have been identified as potential predictors of poor prognosis in patients with hepatocellular carcinoma (HCC), but the role of postoperative inflammatory indicators remains unclear. This study aimed to explore the prognostic value of the postoperative lymphocyte–C-reactive protein ratio (PostLCR) on its own and combined with preoperative LCR (PreLCR). Methods A total of 290 patients with primary HCC were retrospectively enrolled in the study. Univariate analysis was used to identify factors significantly associated with poor disease-free survival (DFS) and overall survival (OS), then multivariate analysis was performed to identify independent prognostic indicators of poor survival. Prognostic models based on preoperative, postoperative, and both types of indicators were then constructed, and their predictive performance were evaluated using time-dependent receiver operating characteristic curves and the concordance index (C-index). Results PreLCR and PostLCR levels correlated with DFS and OS more strongly than other pre- and postoperative inflammatory indicators, respectively. Decreased PreLCR and PostLCR were independent prognostic factors for both DFS and OS, while HCC patients with decreased PreLCR and PostLCR had worse prognosis than patients with increased PreLCR and PostLCR. Patients into three groups based on their cut-off values of PreLCR and PostLCR, Kaplan–Meier survival analysis indicated that HCC patients with low PreLCR and PostLCR had the worst DFS and OS. The combined model showed better predictive performance at 1 and 3 years post-surgery than individual pre- and postoperative models, the American Joint Committee on Cancer/Tumor-Node-Metastasis (8th edition) staging system and the Barcelona Clinic Liver Cancer system. The combine model demonstrated a markedly superior C-index compared with the other models in DFS and OS. Conclusion Our study showed PreLCR and PostLCR are independent predictors of DFS and OS in HCC patients after partial hepatectomy. Models that include both PreLCR and PostLCR can predict prognosis better than well-established clinical staging systems.

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Section: Discussionmentioning

confidence: 99%

“… 9–13 The preoperative lymphocyte–C-reactive protein ratio (PreLCR) has also recently been identified as a powerful prognostic marker in HCC. 14 , 15 …”

Section: Introductionmentioning

confidence: 99%

Combining Pre- and Postoperative Lymphocyte–C-Reactive Protein Ratios Can Better Predict Hepatocellular Carcinoma Prognosis After Partial Hepatectomy

Ni¹,

Zhan²,

Huang³

et al. 2022

JIR

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show abstract

“…LCR has been shown to predict recurrence, prognosis, and postoperative morbidity in various malignancies [ 18 25 ]. It has also been shown to be superior to other inflammation-based markers for predicting the prognosis of patients with surgically resected HCC [ 14 15 16 ]. However, in the aforementioned studies, the AUC analysis of LCR showed poor prognostic performance, and AGR was not considered as a potential prognostic marker.…”

Section: Discussionmentioning

confidence: 99%

“…Lymphocyte-to-CRP ratio (LCR) is a novel prognostic biomarker in colorectal cancer that has proved useful for perioperative management and postoperative follow-up [ 13 14 ]. LCR has also been shown to be an independent prognostic marker in patients with surgically resected HCC [ 15 16 17 ]. However, data on its ability to predict recurrence are lacking.…”

Section: Introductionmentioning

confidence: 99%

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

et al. 2022

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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) 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). Conclusion 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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“…The signi cance of the PLR, NLR and LCR has previously been reported in a variety of adult conditions. It has been shown that NLR, PLR and LCR are useful markers in predicting the prognosis of patients with lung cancer [21], hepatocellular Carcinoma [22],…”

Section: Discussionmentioning

confidence: 99%

Lymphocyte-C reactive protein ratio is a promising indicator for predicting intestinal necrosis in neonates with portal venous gas

Cao

Zhang

Hou

et al. 2022

Preprint

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Purpose: Portal venous gas (PVG) in neonates is a special abdominal imaging, which often indicates the occurrence of intestinal ischemia and necrosis, and is also an indicator to evaluate the severity and surgical timing of neonatal necrotizing enterocolitis. The timely identification and intervention of intestinal necrosis in neonates with PVG is particularly important, but it is still difficult at present. Various inflammatory factors in predicting prognosis and surgery timing have been described in adult literature, but rarely in neonatal literature. Therefore, we investigate the value of inflammatory factors in predicting intestinal necrosis in neonates with PVG.Methods: We retrospectively reviewed the medical records of neonates with PVG detected by ultrasound in a tertiary-level referral hospital from January 2020 to December 2020. During the study period, 168 neonates with ultrasonographically identified PVG were included and were divided into two groups according to the presence of intestinal necrosis: a necrotic group (n=35) and a non-necrotic group(n=133). We evaluated the predictive values of various combination of inflammatory markers in preoperative period laboratory analyses using the receiver operating characteristic (ROC) method. Results: In the current cohort, a total of 168 patients were identified. Of these, 35 patients (20.8%) underwent intestinal resection due to intestinal necrosis and 5 patients (3.0%) developed intestinal stricture after medical management. The overall survival rate was 164/168 (97.6%). In patients with intestinal necrosis, platelet count (p<0.001), lymphocyte count(p<0.001), Eosinophil count(p<0.001), CRP (C-reactive protein, p<0.001), PLR (platelet–lymphocyte ratio, p=0.002), NLR (neutrophil–lymphocyte ratio, p=0.001), LCR (lymphocyte–CRP ratio, p<0.001) and PCR (platelet- CRP ratio, p<0.001) values were significantly different with those in the patients without intestinal necrosis. Receiver operating characteristic (ROC) analysis results showed that the combination of C-reactive protein levels along with lymphocyte count (LCR) had the highest correlation with intestinal necrosis in neonates with portal venous gas [AUC 0.86 (95% CI 0.79–0.94); p<0.001], with sensitivity of 0.81(0.73–0.87) and specificity of 0.86(0.69–0.95) for the diagnosis of intestinal necrosis. Conclusions: The preoperative LCR score is a promising indicator for predicting intestinal necrosis in neonates with PVG, which could be used as an additional criterion to guide surgical management.

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Prognostic Impact of Lymphocyte–C-Reactive Protein Ratio in Patients Who Underwent Surgical Resection for Hepatocellular Carcinoma

Cited by 18 publications

References 28 publications

Combining Pre- and Postoperative Lymphocyte–C-Reactive Protein Ratios Can Better Predict Hepatocellular Carcinoma Prognosis After Partial Hepatectomy

Combining Pre- and Postoperative Lymphocyte–C-Reactive Protein Ratios Can Better Predict Hepatocellular Carcinoma Prognosis After Partial Hepatectomy

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

Lymphocyte-C reactive protein ratio is a promising indicator for predicting intestinal necrosis in neonates with portal venous gas

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