Letters To The Editor
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World J Gastroenterol. Jul 28, 2014; 20(28): 9631-9632
Published online Jul 28, 2014. doi: 10.3748/wjg.v20.i28.9631
Neutrophil-lymphocyte ratio is useful for the prognosis of patients with hepatocellular carcinoma
Huseyin Kayadibi, Erdim Sertoglu, Metin Uyanik, Serkan Tapan
Huseyin Kayadibi, Department of Medical Biochemistry, Adana Military Hospital, Adana 01150, Turkey
Erdim Sertoglu, Biochemistry Laboratory of Anittepe Dispensary, Ankara Mevki Military Hospital, Ankara 06580, Turkey
Metin Uyanik, Serkan Tapan, Department of Medical Biochemistry, GATA School of Medicine, Ankara 06018, Turkey
Author contributions: Kayadibi H, Sertoglu E and Uyanik M wrote this letter; Tapan S revised the letter.
Correspondence to: Huseyin Kayadibi, MD, MSc, Department of Medical Biochemistry, Adana Military Hospital, Seyhan, 01150 Adana, Turkey. mdkayadibi@yahoo.com
Telephone: +90-544-6178931 Fax: +90-322-2272338
Received: January 25, 2013
Revised: February 23, 2014
Accepted: April 5, 2014
Published online: July 28, 2014
Abstract

There is increasing evidence that neutrophil-lymphocyte ratio (NLR) may play a role in predicting recurrence in patients with hepatitis B virus-related hepatocellular carcinoma (HCC) after liver transplantation. In the original study by Yan et al, it was aimed to determine whether an elevated NLR is associated with tumor recurrence. Total tumor size (> 9 cm) and macro-vascular invasion were found to be more significant than NLR according to the multivariate logistic regression analysis. Therefore, substantive significance should be emphasized rather than NLR because total tumor size and macro-vascular invasion are easier and more expressive than NLR in assessing HCC recurrence. NLR and platelet-lymphocyte ratio (PLR) are markers which are easy to obtain and can be used as inflammation indicators. Moreover, assessment of both NLR and PLR may add some value as a good predictor of risk for post-liver transplantation HCC recurrence. However, while the study was constructed on whole blood analysis, further details about the features and performance characteristics of the whole-blood analyzer, and preanalytical/analytical variables should also be mentioned.

Keywords: Hepatocellular carcinoma, Liver transplantation, Neutrophil-lymphocyte ratio, Platelet-to-lymphocyte ratio, Prognosis

Core tip: Neutrophil-lymphocyte ratio (NLR), total tumor size (> 9 cm) and macro-vascular invasion may play a role in the prediction of recurrence in patients with hepatitis B virus-related hepatocellular carcinoma after liver transplantation. Assessment of both NLR and platelet-lymphocyte ratio, as inflammation markers, may increase the prediction rate for these patients. Factors affecting the laboratory results should also be evaluated, in such a study.