Lymphocyte-to-C-reactive protein ratio as a prognostic factor for hepatocellular carcinoma

Norifumi Iseda, Shinji Itoh, Tomoharu Yoshizumi, Takahiro Tomiyama, Akinari Morinaga, Tomonari Shimagaki, Huanlin Wang, Takeshi Kurihara, Takeo Toshima, Yoshihiro Nagao, Noboru Harada, Yoshinao Oda, Masaki Mori

Research output: Contribution to journalArticlepeer-review

23 Citations (Scopus)


Background: Systemic inflammation has been correlated with worse survival for some cancers. We evaluated prognostic values of various inflammatory factor combinations in patients who underwent resections for hepatocellular carcinoma (HCC). Methods: We retrospectively analysed 306 consecutive patients with HCC who underwent curative liver resections. After assessing eight combinations of inflammatory markers for predictive value for recurrence, we focused on lymphocyte-to-C-reactive protein ratio (LCR) to elucidate its associations with recurrence-free survival (RFS) and overall survival (OS) in univariate and multivariate analyses (Cox proportional hazards model). We also used immunohistochemical CD34 and CD8 staining to investigate the mechanism of LCR elevation. Results: LCR showed the highest association with RFS in HCC patients among the compared indices. High preoperative LCR correlated with a high serum albumin concentration, small tumour size, early Barcelona Clinic Liver Cancer stage and low rates of microscopic vascular invasion and microscopic intrahepatic metastasis. Higher preoperative LCR was an independent predictor of longer RFS and OS in this cohort. High LCR patients had fewer vessels encapsulating tumour clusters, and higher intratumoural CD8+ T-cell counts than low LCR patients. Conclusions: Preoperative LCR is a novel and convenient prognostic marker for patients with HCC, and is associated with the tumour microenvironment immune status.

Original languageEnglish
Pages (from-to)1890-1900
Number of pages11
JournalInternational Journal of Clinical Oncology
Issue number10
Publication statusPublished - Oct 2021

All Science Journal Classification (ASJC) codes

  • Surgery
  • Hematology
  • Oncology


Dive into the research topics of 'Lymphocyte-to-C-reactive protein ratio as a prognostic factor for hepatocellular carcinoma'. Together they form a unique fingerprint.

Cite this