To investigate the preoperative plus postoperative neutrophil-lymphocyte ratio (PP-NLR) predicts the outcomes of hepatocellular carcinoma after hepatectomy.

The clinical data of 44 patients with partial hepatectomy in the Hepatobiliary Surgery, Beijing Tsinghua Changgung Hospital, Tsinghua University, from December 2014 to March 2018 were retrospectively analyzed. According to the cut-off value, the high NLR is assigned a value of 1 before and after surgery, and the low NLR is assigned a value of 0. Preoperative NLR plus postoperative NLR=0/1/2. The preoperative NLR plus postoperative NLR=0/1 was assigned to one group, and the preoperative NLR plus postoperative NLR=2 was attributed to one group. Recurrence-free survival (RFS) and overall survival (OS) were evaluated by the Kaplan-Meier method, with comparisons using the log-rank test. The Cox proportional hazard model is used for univariate and multivariate analysis.

Comparison of clinical and pathological data of different PP-NLR, the preoperative and postoperative NLR was higher in the PP-NLR=2 group than in the PP-NLR=1/0 group, and the difference was significant (P<0.05). Univariate analysis showed that PP-NLR (HR=3.495, 95%CI: 1.054~11.589, P<0.05) and degree of differentiation(HR=3.995, 95%CI: 1.050~15.198, P<0.05) were risk factors for OS after liver resection, while preoperative NLR and postoperative NLR alone were not risk factors for overall survival. Multivariate analysis showed that PP-NLR (HR=4.733, 95%CI: 1.320~16.966, P<0.05) and degree of differentiation (HR=6.310, 95%CI: 1.456~27.344, P<0.05) were independent risk factors for OS after liver resection.

PP-NLR considers the systemic immune status of preoperative and postoperative, predicts prognosis better than preoperative or postoperative NLR.

Carcinoma, hepatocellular; Hepatectomy; Neutrophil-lymphocyte ratio (PP-NLR); Prognosis