Neutrophil-to-Lymphocyte Ratio Can Distinguish Patients with Liver Cirrhosis from Healthy People but Cannot Distinguish Patients with Cirrhotic Hepatocellular Carcinoma from Patients with Liver Cirrhosis.

Purpose: Identifying cirrhotic hepatocellular carcinoma (HCC) during liver cirrhosis (LC) stage is pivotal for improving the clinical outcomes of cirrhotic HCC patients. Inflammation-driven markers play a crucial role in tumorigenesis and tumor progression. Neutrophil-to-lymphocyte ratio (NLR) is an inflammatory response marker. This study aimed to evaluate the ability of NLR to distinguish cirrhotic HCC from LC.

Methods: Data of healthy control (HC) people, LC patients, cirrhotic HCC patients, and non-cirrhotic HCC patients were retrospectively analyzed. Mann-Whitney test and Chi-squared test were used to compare demographic and clinical parameters in different groups. Spearman correlation analysis was used to assess correlations. Receiver operating characteristic (ROC) curves were performed to determine diagnostic accuracy.

Results: A total of 419 participants were enrolled in this study, including 152 HC people, 131 LC patients, 96 cirrhotic HCC patients, and 40 non-cirrhotic HCC patients. Level of NLR was elevated significantly in LC compared with HC ( < 0.001). No significant differences were found for NLR between LC and cirrhotic HCC ( = 0.083), as well as between cirrhotic HCC and non-cirrhotic HCC ( = 0.729). NLR was positively correlated with platelet-to-lymphocyte ratio ( = 0.33, < 0.001). The area under the ROC curve (AUC) value for NLR to distinguish LC from HC was 0.759 ( < 0.001), and AUC value to distinguish cirrhotic HCC from LC was 0.567 ( = 0.083), and AUC value to distinguish non-cirrhotic HCC from cirrhotic HCC was 0.519 (0.415-0.623) ( = 0.729).

Conclusion: NLR can distinguish LC from HC but cannot not distinguish cirrhotic HCC from LC.