title: Preoperative lymphocyte-to-monocyte ratio predicts survival in primary hepatitis B virus-positive hepatocellular carcinoma after curative resection.
abstract: BACKGROUND
  Both inflammation and immunity are associated with the development of malignancy. The lymphocyte-to-monocyte ratio (LMR) has been confirmed as a prognostic factor for several malignant diseases. The purpose of our study was to analyze prognostic significance of preoperative LMR in hepatitis B virus (HBV)-related hepatocellular carcinoma after curative resection.
  
  
  METHODS
  A total of 253 patients with primary HBV-positive hepatocellular carcinoma who underwent a curative operation were enrolled in this retrospective study. The relationship between preoperative LMR and survival outcomes was analyzed through Kaplan-Meier curves and multivariate Cox regression analyses.
  
  
  RESULTS
  Patients with a high LMR had a significantly higher mean overall survival than those with a low LMR (67 months vs 55 months,P=0.023), and high LMR remained significant for longer survival in the multivariate analysis (hazard ratio, 0.147; 95% confidence interval [CI]: 0.085-0.253;P=0.021). Furthermore, patients with a high LMR also had a higher median recurrence-free survival than those with a low LMR in univariate analyses (60 months vs 48 months,P=0.026) and multivariate analyses (hazard ratio, 0.317; 95% CI: 0.042-1.023;P=0.032). However, the survival benefit was limited to patients with advanced cancer.
  
  
  CONCLUSIONS
  LMR was confirmed as an independent prognostic biomarker for primary HBV-positive hepatocellular carcinoma after curative resection.
authors.affiliation: First Department of General Surgery.
authors.forename: Guang-Jun
authors.initials: GJ
authors.lastname: Li
authors.affiliation: Department of Gastroenterology.
authors.forename: Juan-Juan
authors.initials: JJ
authors.lastname: Ji
authors.affiliation: Department of Gastroenterology.
authors.forename: Fang
authors.initials: F
authors.lastname: Yang
authors.affiliation: First Department of General Surgery.
authors.forename: Hong-Wei
authors.initials: HW
authors.lastname: Xu
authors.affiliation: Department of Pathology, The First Affiliated Hospital of Xin-Xiang Medical University, Henan, People's Republic of China.
authors.forename: Yu
authors.initials: Y
authors.lastname: Bai
keywords: HBV; hepatocellular carcinoma; lymphocyte-to-monocyte ratio; survival