Preoperative neutrophil-to-lymphocyte ratio and tumor-related factors to predict microvascular invasion in patients with hepatocellular carcinoma

// Yanlong Yu 1 , Jiuling Song 1 , Ran Zhang 1 , Zhonghua Liu 1 , Qiang Li 1 , Ying Shi 1 , Ying Chen 1 and Jinming Chen 1 1 Department of General Surgery, Chifeng Municipal Hospital, Inner Mongolia Medical University institute of clinical, Chifeng 024000, Inner Mongolia Autonomous Region, China Correspondence to: Jinming Chen, email: chenjinming0998@163.com Keywords: hepatocellular carcinoma, microvascular invasion, neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, prognosis Received: May 18, 2017 Accepted: June 29, 2017 Published: July 12, 2017 ABSTRACT Small hepatocellular carcinoma (HCC) is less invasive and has a better prognosis, but it still has a high recurrence rate. Microvascular invasion (MVI), as a poor prognostic indicator, is of great importance for treating of patients with HCC. The objective of the present study was to evaluate the predictive value of preoperative neutrophil-to-lymphocyte ratio and possible clinical parameters to MVI in patients with HCC. A total of 157 operable patients with HCC having a tumor diameter of less than or equal to 5 cm were enrolled in this study. The utility of neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, and other clinical parameters was evaluated using receiver operating characteristic curves. MVI was identified as an independent influencing factor for disease-free survival in patients with HCC who underwent curative resection, using the multivariate Cox proportional hazards regression model. The independent parameters associated with MVI were determined using logistic analysis. Multivariate analyses indicated that the neutrophil-to-lymphocyte ratio [hazard ratio, 1.705; 95% confidence interval, 0.467–6.232; P = 0.022)], platelet-to-lymphocyte ratio (hazard ratio, 1.048; 95% confidence interval, 1.006–1.092; P = 0.025), and a-fetoprotein (hazard ratio, 1.012; 95% confidence interval, 1.003–1.021; P = 0.007) were significantly associated with MVI independently. Therefore, this study concluded that the preoperative neutrophil-to-lymphocyte ratio and a-fetoprotein might serve as useful biomarkers for predicting MVI in patients with HCC.