Abstract: Objective To analyze the relationship between preoperative neutrophil/lymphocyte ratio (NLR) and liver failure after hepatectomy in patients with primary hepatic carcinoma, and to guide the future prediction and prevention of liver failure after hepatectomy in patients with primary hepatic carcinoma.Methods A retrospective analysis was conducted. Two hundred and seventy-four patients with primary hepatic carcinoma who underwent hepatectomy treatment and were followed up postoperatively in our hospital from March 2017 to November 2019 were collected as liver cancer group, 67 patients with pathologically confirmed benign liver tumors were collected as control group. The levels of neutrophils (NE), lymphocytes (LY) and NLR of the two groups were detected and compared before operation; the patients of liver cancer group were divided into liver failure group and non-hepatic failure group according to whether liver failure occurred after hepatectomy, comparing the levels of NE, LY and NLR of the two groups before the operation to analyze the influence of the preoperative NLR level on the occurrence of liver failure after hepatectomy, and the receiver operator characteristic (ROC) curve was conducted to analyze the predictive value of preoperative NLR levels on the risk of liver failure after hepatectomy.Results The levels of NE and NLR before operation in the liver cancer group were statistically significant higher than those in the control group, and the LY level was lower than that in the control group (P<0.05). Liver failure occurred in 32 patients of the liver cancer group after hepatectomy, the incidence rate was 11.68%; the levels of NE and NLR before operation of liver failure group were higher than those of the non-hepatic failure group, and the LY level was lower than that of the non-hepatic failure group, the difference was statistically significant (P<0.05). The binary logistic regression analysis showed that NLR overexpression before surgery was an influencing factor for the occurrence of liver failure after hepatectomy in patients with primary hepatic carcinoma (OR>1, P<0.05); ROC curve was conducted and the area under the curve (AUC) of the preoperative NLR level predicting the occurrence of liver failure after hepatectomy was: 0.812 > 0.80, the predictive value was ideal.Conclusion The NLR level of patients with primary hepatic carcinoma is generally high, which may indicate the risk of liver failure after surgery. The preoperative NLR level can be a clinical risk factor to predict the occurrence risk of liver failure in patients with primary hepatic carcinoma after hepatectomy, and guide early risk assessment, prevention and treatment.

Key words: Primary hepatic carcinoma, Hepatectomy, Liver failure, Neutrophils/lymphocytes, Correlation