Prognostic Value of Pre-Operative Platelet to Lymphocyte Ratio in Patients with Resected Primary Hepatocellular Carcinoma.
BACKGROUND
The platelet to lymphocyte ratio (PLR) is a readily available cancer biomarker but its prognostic value for patients with resected primary hepatocellular carcinoma (HCC) is uncertain. Thus, we investigated the relationship between PLR and survival of patients with resected primary HCC in the Fujian area, a high occurrence area of HCC in China.


METHODS
This retrospective study included 337 patients with primary HCC who underwent surgical removal of primary liver cancer between 2004 and 2012 in Fuzhou General Hospital in Fujian, China. Pre-operative peripheral blood PLR was measured by platelet counts divided by lymphocyte counts. PLR and clinical factors were associated with a X2 test and data were analyzed with a Kaplan-Meier plus log rank analysis. Independent prognostic factors related to survival were assessed with multivariable analysis.


RESULTS
Subjects were classified by a median PLR value of 91 (low: ≤ 91, n = 169 and high: > 91, n = 168). HighPLR patients died more often (57.7% vs. 35.5%, p = 4.3 x 10-5 and 39 months vs. 88 months, p < 0.001, respectively) and high PLR was associated with a nearly 2-fold elevated death risk (hazard ratio [HR]:1.815, 95% confidence interval (CI): 1.298 - 2.537, p = 4.85 x 10-4). Serum AFP, TNM stage and tumor size were also independent prognostic factors for patients with resected primary HCC according to multivariable analysis.


CONCLUSIONS
PLR may be useful as a biomarker for assessing survival of resected primary HCC patients.
Lihong
L
Dong
Kai
K
Bai
Yi
Y
Cao
Qiaojia
Q
Huang
Lizhi
L
Lv
Yi
Y
Jiang
D001792:Blood Platelets; D006528:Carcinoma, Hepatocellular / Q000097:blood* / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D016009:Chi-Square Distribution; D002681:China; D005260:Female; D006498:Hepatectomy / Q000009:adverse effects / Q000401:mortality; D006769:Hospitals, General; D006801:Humans; D053208:Kaplan-Meier Estimate; D008113:Liver Neoplasms / Q000097:blood* / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D018655:Lymphocyte Count; D008214:Lymphocytes; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009367:Neoplasm Staging; D010976:Platelet Count; D011237:Predictive Value of Tests; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome; D047368:Tumor Burden; D000509:alpha-Fetoproteins / Q000032:analysis
C097353:AFP protein, human; D000509:alpha-Fetoproteins