Prognostic Significance of Platelet-to-Lymphocyte Ratio (PLR) in Extrahepatic Metastasis of Hepatocellular Carcinoma After Curative Resection

Abstract

Background The prognosis for patients diagnosed of hepatocellular carcinoma (HCC) who have extrahepatic metastasis after liver resection is unsatisfactory. This study aimed to find out the relationship between the inflammation-related indexes and metastasis. Methods One thousand three hundred and sixty-six patients diagnosed of HCC who underwent curative resection were included in this study and divided into metastasis group (n=180) and non-metastasis group (n=1186). A receiver operating characteristic (ROC) curve was constructed to estimate the optimal cut-off value for inflammation-related indexes. Independent risk factors were identified by Cox regression analysis. The metastasis rate was analyzed by the Kaplan-Meier method, then the subgroup analyses were taken. Results The cut-off values of NLR, PLR, LMR, NγLR, PNLR, and PNI were 2.65, 107.67, 5.47, 134.52, 335.03, and 51.23, respectively. Multivariate Cox analysis revealed that elevated serum AFP level (P=0.004), tumor size more than 5cm (P<0.001), multiple tumors (P=0.040), and higher PLR (P=0.042) were independent risk factors associated with extrahepatic metastasis. The Kaplan-Meier method showed that the high PLR group has a higher extrahepatic metastasis rate than the low PLR group. Meanwhile, the results of subgroup analyses were consistent with the conclusion. Conclusion The PLR is an independent risk factor of extrahepatic metastasis after radical hepatectomy for HCC patients. The high PLR indicates a higher rate of extrahepatic metastasis.

Biomarkers of Inflammation and Inflammation-Related Indexes upon Emergency Department Admission Are Predictive for the Risk of Intensive Care Unit Hospitalization and Mortality in Acute Poisoning: A 6-Year Prospective Observational Study

“…However, the prognostic accuracy of the models including the SII and PLR in our cohort was not better compared with the models including NLR and MLR. This is in opposition with the results of other studies on SII and PLR, which showed a prognostic accuracy in cancer patients [42,43], as well as a good predictive role for neurological long-term complications in CO-poisoned patients [23], probably because we were interested only in short-term outcomes and we did not analyze the long-term effect of these indices. Thrombocytopenia might appear after the oxidative stress which negatively affects the platelet membranes, as it does in all blood cells.…”

Correlation Between Platelet-Lymphocyte Ratio and Neutrophil-Lymphocyte Ratio in Patients with Uterine Leiomyoma: A Cross-Sectional Study

“…In addition, PLR is an independent risk factor for the prognosis of coronavirus disease in 2019 [ 18 , 19 ], and a high PLR is significantly associated with mortality. A clinical study [ 20 ] also showed that PLR is an independent risk factor for postoperative metastasis of malignant tumors, and a high PLR indicates a higher rate of postoperative metastasis. Several differential diagnosis studies [ 14 , 21 ] have shown that PLR is an important index for establishing a predictive model for the diagnosis of leiomyoma.…”

“…Several studies [34][35][36] have pointed out that inflammation plays an important role in the pathogenesis of uterine leiomyoma, as well as in the development of fibroid fibrosis and disease progression. Many studies [20,23,37,38] have also reported that PLR and NLR can reflect the inflammatory state of the body in the absence of infectious diseases. In the current study, NLR showed an upward trend with an increase in PLR in patients with multiple uterine fibroids.…”

Update on perioperative management of patients undergoing surgery for liver cancer

“…Recent studies have proposed markers based on several nutritional or inflammation‐based prognostic indicators of HCC. Nutritional‐ or inflammation‐based markers include the prognostic nutritional index, 32 , 33 , 34 controlling nutritional status (CONUT) score, 35 , 36 , 37 Glasgow prognostic score, 38 C‐reactive protein (CRP)‐to‐albumin ratio (CAR), 39 neutrophil‐to‐lymphocyte ratio (NLR), 40 platelet‐to‐lymphocyte ratio (PLR), 41 , 42 lymphocyte‐to‐monocyte ratio (LMR), 43 , 44 and CRP‐albumin‐lymphocyte index. 45 Table 1 shows combined indices that can reportedly be used to estimate the nutritional or inflammatory status relevant to short‐ and long‐term outcomes after hepatectomy for HCC.…”