Evaluation of the prognostic value of platelet to lymphocyte ratio in patients with hepatocellular carcinoma.

Background: Hepatocellular carcinoma (HCC) is increasingly common, potentially fatal cancer type globally. Platelet-lymphocyte ratio (PLR) as a biomarker for systemic inflammation has recently been recognized as a valuable prognostic marker in multiple cancer types. The aim of the present study was to assess the prognostic value of PLR in HCC patients and determine the optimal cut-off value for risk stratification.

Methods: We retrospectively analyzed patients with diagnosis of HCC (screened by ICD-9 code, confirmed with radiographic examination and/or biopsy) at a large public hospital during 15 years (Jan 2000 through July 2015). PLR, among other serology laboratory values were collected at diagnosis of HCC. Its association with overall survival was evaluated with Cox proportional hazard model.

Results: Among 270 patients with HCC, 57 (21.1%) patients died within an average follow-up of 11.9 months. PLR at diagnosis was significantly different between survivors and deceased (128.9 vs. 186.7; P=0.003). In multivariate analysis, aspartate transaminase (AST) (HR 2.022, P<0.001) and PLR (HR 1.768, P=0.004) independently predicted mortality. The optimal cut-off value for PLR was determined to be 220 by receiver-operating characteristics curve, and high PLR group had significantly higher mortality (HR 3.42, P<0.001).

Conclusions: Our results indicated that elevated PLR at diagnosis above 220 predicted poor prognosis in HCC patients. PLR is a low-cost and convenient tool, which may serve as a useful prognostic marker for HCC.