title: Platelet-to-lymphocyte ratio acts as a prognostic factor for patients with advanced hepatocellular carcinoma.
abstract: The platelet count, as an inflammation marker, is involved in the progress of tumor invasion. However, the prognostic value of platelet counts and the platelet-to-lymphocyte ratio (PLR) has not been investigated in patients with advanced hepatocellular carcinoma (HCC). This study aimed to determine the prognostic value of platelet counts and PLR in HCC patients. A total of 243 ethnic Chinese advanced HCC patients from two major hospitals, not receiving systemic sorafenib, were analyzed retrospectively. The prognostic value of differential blood cell counts and PLR for overall survival (OS) was determined by integrating the Cancer of the Liver Italian Program (CLIP) score system and model for end-stage liver disease by using a stepwise model of multivariate Cox regression. The Kaplan-Meier method and receiver operating characteristic (ROC) curves were utilized accordingly. PLR was confirmed to be an independent predictor for OS (p < 0.01), while the remaining parameters had no predictive value. Then, advanced HCC patients were dichotomized into two groups based on the PLR value (≤111.23 or >111.23), according to ROC analysis. Patients with a high PLR had a lower 3-month survival rate (37.6 vs. 57.6%) compared with patients with a low PLR. PLR was associated with aggressive malignant behavior, characterized by distant metastasis and portal vein thrombosis. Additionally, PLR was not associated with the CLIP score and Child-Pugh grade. PLR was identified as an independent prognostic factor for advanced HCC patients not receiving systemic sorafenib; the predictive ability of PLR partially relies on its association with the aggressive nature of HCC.
authors.affiliation: Department of Medical Oncology, The Third Affiliated Hospital of Sun Yat-sen University, 600 Tianhe Road, Guangzhou, 510630, People's Republic of China.
authors.forename: Xing
authors.initials: X
authors.lastname: Li
authors.forename: Zhan-Hong
authors.initials: ZH
authors.lastname: Chen
authors.forename: Yan-Fang
authors.initials: YF
authors.lastname: Xing
authors.forename: Tian-Tian
authors.initials: TT
authors.lastname: Wang
authors.forename: Dong-Hao
authors.initials: DH
authors.lastname: Wu
authors.forename: Jing-Yun
authors.initials: JY
authors.lastname: Wen
authors.forename: Jie
authors.initials: J
authors.lastname: Chen
authors.forename: Qu
authors.initials: Q
authors.lastname: Lin
authors.forename: Min
authors.initials: M
authors.lastname: Dong
authors.forename: Li
authors.initials: L
authors.lastname: Wei
authors.forename: Dan-Yun
authors.initials: DY
authors.lastname: Ruan
authors.forename: Ze-Xiao
authors.initials: ZX
authors.lastname: Lin
authors.forename: Xiang-Yuan
authors.initials: XY
authors.lastname: Wu
authors.forename: Xiao-Kun
authors.initials: XK
authors.lastname: Ma
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001772:Blood Cell Count; D001792:Blood Platelets / Q000473:pathology*; D006528:Carcinoma, Hepatocellular / Q000097:blood* / Q000473:pathology; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008113:Liver Neoplasms / Q000097:blood* / Q000473:pathology; D008214:Lymphocytes / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D010976:Platelet Count; D011379:Prognosis