title: [Preoperative neutrophil-lymphocyte ratio as a prognostic predictor after liver transplantation for hepatocellular carcinoma].
abstract: OBJECTIVE
  To analyze the negative impact of preoperative neutrophil-lymphocyte ratio (NLR) on the tumor recurrence of hepatocellular carcinoma (HCC) after orthotopic liver transplantation.
  
  
  METHODS
  The clinical data of HBV (hepatitis B virus)-associated HCC patients undergoing liver transplantation were retrospectively analyzed. Their clinical and pathological risk factors for tumor-free survival were evaluated by univariate analysis. The analysis of Cox multiple regression was performed to determine the parameters of predicting the HCC recurrence. NLR ≥ 2.5 was considered to be elevated.
  
  
  RESULTS
  A total of 76 patients were identified. Among them, 37 had an elevated NLR. The 1, 3 and 5-year tumor-free survival rates were 69.2%, 52.7% and 50.9% respectively. The disease-free survival for patients with high NLR was significantly worse than that for those with normal NLR (1, 3, and 5 year survivals at 56.3%, 37.6% and 37.6% vs 81.1%, 66.9% and 63.3% respectively; P = 0.011). Univariate analysis of factors revealed that tumor size > 5 cm, tumor number > 3, vascular invasion, serum α-fetoprotein level ≥ 400 µg/L and NLR ≥ 2.5 were preoperative predictors of disease-free survival. Cox regression analysis showed that the presence of vascular invasion, tumor number > 3 and NLR ≥ 2.5 were independent prognostic factors of worse disease-free survival.
  
  
  CONCLUSIONS
  An elevated NLR significantly increases the risk for tumor recurrence in HCC patients undergoing liver transplantation.
authors.affiliation: Sun Yat-sen University, Guangzhou 510630, China.
authors.forename: Guo-ying
authors.initials: GY
authors.lastname: Wang
authors.forename: Yang
authors.initials: Y
authors.lastname: Yang
authors.forename: Qi
authors.initials: Q
authors.lastname: Zhang
authors.forename: Hua
authors.initials: H
authors.lastname: Li
authors.forename: Guan-zhong
authors.initials: GZ
authors.lastname: Chen
authors.forename: Shu-hong
authors.initials: SH
authors.lastname: Yi
authors.forename: Chi
authors.initials: C
authors.lastname: Xu
authors.forename: Gen-shu
authors.initials: GS
authors.lastname: Wang
authors.forename: Jian
authors.initials: J
authors.lastname: Zhang
authors.forename: Hui-min
authors.initials: HM
authors.lastname: Yi
authors.forename: Nan
authors.initials: N
authors.lastname: Jiang
authors.forename: Bin-sheng
authors.initials: BS
authors.lastname: Fu
authors.forename: Hui
authors.initials: H
authors.lastname: Zhao
authors.forename: Min-ru
authors.initials: MR
authors.lastname: Li
authors.forename: Ying-hua
authors.initials: YH
authors.lastname: Chen
authors.forename: Chang-jie
authors.initials: CJ
authors.lastname: Cai
authors.forename: Min-qiang
authors.initials: MQ
authors.lastname: Lu
authors.forename: Gui-hua
authors.initials: GH
authors.lastname: Chen
mesh_terms: D000328:Adult; D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000401:mortality / Q000473:pathology* / Q000601:surgery; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000401:mortality / Q000473:pathology* / Q000601:surgery; D016031:Liver Transplantation / Q000401:mortality; D008214:Lymphocytes / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000473:pathology*; D009504:Neutrophils / Q000473:pathology; D016017:Odds Ratio; D011237:Predictive Value of Tests; D011379:Prognosis; D012189:Retrospective Studies; D015996:Survival Rate