ABSTRACT
Objective:To investigate the predictive effect of neutrophil to lymphocyte ratio (NLR) for recurrence-free survival after liver transplantation in hepatocellular carcinoma (HCC) patients.Methods:The clinical data of 84 HCC patients who underwent liver transplantation in the 900th Hospital of the Joint Logistics Team, PLA, from January 2012 to December 2019 were included in this retrospective analysis. There were 73 males and 11 females, with an average age of 51 years. Univariate and multivariate Cox regression analyses were performed. The distinguishing ability of NLR for predicting recurrence-free survival in patients with HCC after liver transplantation was analyzed using the receiver operating characteristic (ROC) curvee. The two groups were generated according with the cut-off value, and the recurrence-free survival time to make the Kaplan-Meier survival curve.Results:The area under the ROC curve of NLR for predicting recurrence-free survival after liver transplantation in patients with HCC was 0.683, Yoden index was 0.319, and the optimal threshold was 3.2.Univariate analysis showed that maximum tumor diameter, number of tumors, Milan criteria, and NLR were associated with recurrence-free survival after liver transplantation in patients with HCC (all P<0.05). Multivariate analysis showed that maximum tumor diameter ( HR=2.412, 95% CI: 1.277-4.555), number of tumors ≥3 ( HR=5.595, 95% CI: 2.023-17.531) and NLR≥3.2 ( HR=2.891, 95% CI: 1.348-6.204) were independent risk factors for recurrence-free survival of HCC patients prediction after liver transplantation (all P<0.05). The 1-year recurrence-free survival rate was 78% in the NLR<3.2 group ( n=61), which was superior to 58% in the NLR≥3.2 group ( n=23), and the difference was statistically significant ( P<0.05). Conclusion:Tumor diameter, number of tumors and NLR are risk factors affecting the prognosis of liver transplantation in patients with HCC, and high serum NLR may indicate recurrence-free survival in patients with HCC after liver transplantation.