Value of platelet-to-lymphocyte ratio and neutrophil-to-lymphocyte ratio in prognostic evaluation of patients with long-term survival after radiofrequency ablation for hepatocellular carcinoma

Objective To investigate the value of platelet-to-lymphocyte ratio ( PLR) and neutrophil-to-lymphocyte ratio ( NLR) in the prognostic evaluation of hepatocellular carcinoma ( HCC) patients with a survival time of > 5 years after radiofrequency ablation. Methods A total of 135 HCC patients who underwent transcatheter arterial chemoembolization combined with radiofrequency ablation in Beijing YouAn Hospital, Capital Medical University, from June 2006 to February 2012 and had a survival time of > 5 years were enrolled. Baseline laboratory and imaging data were collected, and NLR and PLR were calculated based on routine blood test results. The chi-square test was used for comparison of categorical data between groups. The receiver operating characteristic ( ROC) curve was used to determine the cut-off values of NLR and PLR; the Kaplan-Meier method was used to plot survival curves, and the log-rank test was used to compare survival rates; the indices with statistical differences in the log-rank test were included in the Cox multivariate analysis. Results According to the ROC curve, the cut-off value of NLR was 2. 08 and that of PLR was 96. 82. According to the cut-off values of NLR and PLR before treatment, the patients were divided into low NLR group ( NLR < 2. 08, 60 patients) and high NLR group ( NLR≥2. 08, 75 patients) , as well as low PLR group ( PLR < 96. 82, 78 patients) and high PLR group ( PLR≥96. 82, 57 patients) . There were significant differences between the low NLR group and the high NLR group in alpha-fetoprotein ( AFP) and BCLC stage ( χ2= 15. 125 and 9. 649, both P < 0. 05) , and there were significant differences between the low PLR group and the high PLR group in AFP, cholinesterase ( ChE) , BCLC stage, and tumor size ( χ2= 25. 511, 4. 220, 9. 265, and 16. 403, P < 0. 05) . The low NLR group had a significantly higher survival rate than the high NLR group ( χ2= 31. 302, P < 0. 01) , and the low PLR group had a significantly higher survival rate than the high PLR group ( χ2=92. 905, P < 0. 01) . The Cox multivariate analysis showed that preoperative PLR ( odds ratio [OR] = 9. 634, 95% confidence interval[CI]5. 167-17. 964, P < 0. 001) , ChE ( OR = 0. 404, 95% CI: 0. 236-0. 692, P = 0. 001) , tumor diameter ( OR = 3. 861, 95% CI:1. 760-8. 472, P = 0. 001) , and BCLC stage ( OR = 9. 607, 95% CI: 1. 228-75. 151, P = 0. 031) were independent influencing factors for the survival rate of HCC patients with a long-term survival time ( > 5 years) after radiofrequency ablation. Conclusion PLR is an independent risk factor for survival rate of HCC patients with a long-term survival time after radiofrequency ablation, and the prognosis tend to become worse with the increase in PLR. With reference to tumor conditions, it can be used as an important prognostic indicator for the long-term survival of HCC patients after radiofrequency ablation.