Abstract: Objective To evaluate the predictive value of preoperative serum alpha-fetoprotein (AFP) level and neutrophil-to-lymphocyte ratio (NLR) in the prognosis of patients with hepatocellular carcinoma (HCC). Methods The clinical data of 88 patients with HCC who underwent surgery in our hospital from February 2014 to February 2016 were retrospectively analyzed. According to the prognosis, they were divided into a good prognosis group and a poor prognosis group. The gender, age, the tumor, node, metastasis (TNM) stage, tumor diameter, lymph node metastasis, hepatitis B virus infection, AFP, and NLR between the 2 groups were compared. The value of AFP and NLR in predicting poor prognosis of HCC patients was analyzed by receiver operator characteristic curve. And risk factors for poor prognosis of HCC were identified by multivariate logistic regression analysis. Results There was no difference between the 2 groups in sex, age or the incidence of hepatitis B virus infection (P>0.05). In poor prognosis group, cases of TNM stage III or IV, tumor diameter ≥ 60 mm and lymph node metastasis were significantly more than those in good prognosis group (P<0.05). AFP and NLR in poor prognosis group were significantly higher than those in good prognosis group (P<0.05). The area under the curve of AFP and NLR predicting the poor prognosis of HCC patients was 0.839 and 0.815, respectively (P<0.05). Multivariate logistic regression analysis confirmed that TNM stage III or IV, tumor diameter ≥ 60 mm, lymph node metastasis, AFP ≥ 444.26 ng/mL, NLR ≥ 2.65 were risk factors for poor prognosis of HCC patients (P<0.05). Conclusion The prognosis of HCC is affected by many factors. When AFP ≥ 444.26 ng/mL or NLR ≥ 2.65, the prognosis of HCC patients tends to be poor, which should be paid attention to in clinical treatment.

Key words: Hepatocellular carcinoma, Alpha-fetoprotein, Neutrophil-to-lymphocyte ratio, Prognosis