Usefulness of the Neutrophil-to-lymphocyte Ratio and Platelet Morphologic Parameters in Predicting Hepatic Fibrosis in Chronic Hepatitis C Patients.

Background: Chronic hepatitis C (CHC) can progress to fibrosis and cirrhosis. The current gold standard for the diagnosis and staging of hepatic fibrosis is liver biopsy, but liver biopsies have various limitations. We evaluated the neutrophil-to-lymphocyte ratio (NLR) and platelet morphologic parameters to determine fibrosis in CHC patients.

Methods: We retrospectively reviewed the data of 144 patients who were diagnosed with CHC by percutaneous liver biopsy. Patients' fibrosis scores and histological activity indices were calculated according to the Ishak scoring system.

Results: Eighty-six patients (60%) were female, and the mean age of the whole group was 53.7 years. The low fibrosis (F1-2) group included 56 patients, the high fibrosis group (F3-6) included 88 patients, and the cirrhosis group (F5-6) included 38 patients. There was no statistically significant difference between low and high fibrosis groups or cirrhotic and noncirrhotic groups in terms of NLR. However, plateletcrit (PCT) was significantly lower in patients with cirrhosis and high fibrosis.

Conclusions: NLR is not associated with histological severity and is not an adequate test to determine either significant fibrosis or cirrhosis. For the first time in the literature, this study showed that PCT was significantly lower in patients with significant fibrosis and that NLR was positively correlated with cholestatic liver enzyme leves.