The Predictive Value of Dynamic Changes in Neutrophil-to-lymphocyte Ratio for the Prognosis of Hepatocellular Carcinoma Patients Treated with Transartserial Chemoembolization

Background: Inflammatory biomarkers, including the neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR), serve as crucial indicators of tumor-immune system interactions and reflect the tumor immune microenvironment. Extensive research has demonstrated the significant prognostic potential of baseline inflammatory indices in tumor prediction. Nevertheless, The correlation between the temporal variations of these biomarkers during transartserial chemoembolization (TACE) for hepatocellular carcinoma (HCC) and therapeutic response warrants further investigation. Methods: This retrospective cohort study analyzed clinical data from HCC patients undergoing TACE between 2020 and 2023. Preoperative NLR, postoperative NLR, and three-month postoperative NLR values were collected to assess tumor response status and prognostic outcomes. The study cohort comprised 157 patients. Logistic regression analysis was performed using the objective response rate at the three-month follow-up to identify predictive factors. Subsequently, patients were stratified based on the optimal cut-off value derived from ROC curve analysis, followed by survival and prognostic analyses. Results: The longitudinal change in NLR from preoperative to three-month follow-up, rather than the preoperative NLR baseline value, emerged as a significant predictor of objective response at the three-month follow-up. And an elevated NLR trajectory was more strongly associated with tumor progression. Furthermore, increased NLR changes were correlated with inferior overall survival outcomes (median survival: 26.326 months vs. 20.294 months, p = 0.005). Conclusion: The dynamic alterations in the NLR demonstrate a significant correlation with therapeutic outcomes in HCC patients under TACE. This biomarker exhibits potential as a prognostic indicator for identifying TACE-responsive patients, thereby offering valuable guidance for subsequent therapeutic decision-making.