Prognostic Value of Blood Neutrophils to Lymphocytes Ratio in Patient with HCC Treated with Radiofrequency

Abstract

SUMMARY H Summary

Hepatocellular carcinoma is a primary cancer of the liver and occurs predominantly in patients with underlying chronic liver disease and cirrhosis. The treatment of HCC include Resection, Liver transplantation, Percutaneous radio frequency ablation (RFA), Microwave coagulation therapy (MCT), Transarterial chemoembolization (TACE), Sorafenib, Bevacizumab, Sunitinib. Percutaneous radio frequency ablation (RFA) is an exciting approach to destroying inoperable primary or metastasis tumors in the liver. Inflammation may play an important role in cancer progression, and a high neutrophil-to-lymphocyte ratio (NLR) has been reported to be a poor prognostic indicator in several malignancies. In the “NLR”, “N” represents the number of circulating neutrophils, and it could represent the levels of circulating angiogenesis-regulating chemokines, growth factors and proteases which are major contributors to tumor related angiogenesis. On the other hand, “L” represents the number of circulating lymphocyte, which have pivotal roles in cytotoxic cell death and cytokines production that inhibit proliferation and metastatic activity of tumor cells. This study was conducted in Ain Shams University Hospital to evaluate NLR as a predictor of HCC recurrence after Radiofrequency. It included 30 patients underwent Radiofrequency for HCC, recurrence occurred in 40 % of patients after one month and 43.3 % after three monthes. The median NLR was higher in patients with inadequate ablation than patients with adequate ablation, it was statistically significant in CBC before RF, but highly significant in F.U CBC. A