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REVIEW ARTICLE

Neutrophil-to-lymphocyte and platelet-to-lymphocyte ratios in hepatocellular carcinoma: From inflammation to clinical applications

Yusra Zarlashat1 ,  Tayyeba A1 ,  Shoukat Hussain1*
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1 Department of Biochemistry, Government College University Faisalabad, Faisalabad, Pakistan
CP 2024, 6(4), 5758
Submitted: 4 November 2024 | Accepted: 17 December 2024 | Published: 31 December 2024
© 2024 by the Author(s). This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution 4.0 International License ( https://creativecommons.org/licenses/by/4.0/ )
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Abstract

Hepatocellular carcinoma (HCC) is the predominant type of primary liver cancer, with a rising global incidence and a high mortality rate. Chronic infections with hepatitis viruses, along with risk factors such as cirrhosis, metabolic dysfunction-associated steatohepatitis, and metabolic disorders, significantly contribute to HCC development. Systemic inflammation plays a key role in HCC pathogenesis, with inflammatory markers such as the neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) emerging as significant prognostic indicators. Elevated NLR and PLR are associated with poor overall survival and progression-free survival in HCC patients, reflecting an imbalance in the immune response and tumor microenvironment (TME). Neutrophils and platelets contribute to tumor progression by promoting inflammation, angiogenesis, and immune evasion, while lymphocytes, particularly CD8+ T-cells, play essential roles in antitumor immunity. High levels of NLR and PLR are linked to adverse clinical outcomes, including shorter survival times and higher recurrence rates. These ratios provide valuable prognostic information and are increasingly utilized in clinical settings to guide treatment decisions. This review focuses on the roles of inflammatory markers, particularly NLR and PLR, in HCC progression and prognosis, examining their effects on the TME and their potential for improving diagnostic and prognostic strategies. The use of these inflammatory markers and emerging technologies holds promise for enhancing early detection and personalized treatment strategies, ultimately improving patient outcomes in HCC.

Keywords
Hepatocellular carcinoma
Tumor microenvironment
Immune profiling
Neutrophil-to-lymphocyte ratio
Platelet-to-lymphocyte ratio
Diagnosis
Funding
None.
Conflict of interest
The authors declare that they have no competing interests.
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Cancer Plus, Electronic ISSN: 2661-3840 Print ISSN: 2661-3832, Published by AccScience Publishing
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