Research Paper Volume 13, Issue 4 pp 5358—5368

The lymphocyte-C-reactive protein ratio as the optimal inflammation-based score in patients with hepatocellular carcinoma underwent TACE

Liang-He Lu1, *, , Wei Wei1, *, , Shao-Hua Li1, , Yong-Fa Zhang2,3, , Rong-Ping Guo1, ,

  • 1 Department of Hepatobiliary Oncology, Sun Yat-Sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou 510060, China
  • 2 Department of Hepatic Surgery, Fudan University Shanghai Cancer Center, Shanghai 200032, China
  • 3 Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China
* Equal contribution

Received: April 10, 2020       Accepted: December 16, 2020       Published: February 11, 2021
How to Cite

Copyright: © 2021 Lu et al. This is an open access article distributed under the terms of the Creative Commons Attribution License (CC BY 3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.


The lymphocyte-C-reactive protein ratio (LCR) is a recently described inflammation-based score, and it remains unclear which is the optimal inflammation-based score among patients with hepatocellular carcinoma (HCC) who underwent transarterial chemoembolization (TACE). A large cohort of HCC patients (n=1625) who underwent TACE as the initial treatment were enrolled in the present study. Inflammation-based scores, including the Glasgow Prognostic Score (GPS), modified Glasgow Prognostic Score (mGPS), high-sensitivity modified Glasgow Prognostic Score (Hs-mGPS), neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), prognostic nutritional index (PNI), systemic immune-inflammation index (SII), and LCR, were all related to the survival of HCC patients, but only the LCR score was a significant and independent predictor in multivariate analysis (hazard ratio: 1.45; 95% confidence interval: 1.27-1.65; P<0.001). Further analysis showed that the LCR score stably and consistently differentiated subgroup patients with distinct prognoses. The predictive accuracies of the LCR score (0.70, 0.68, and 0.68 for 1-, 3-, and 5-year C-index, respectively) were superior to the other inflammatory-based scores (0.60-0.64, 0.58-0.62, and 0.58-0.62 for 1-, 3-, and 5-year C-index, respectively). The LCR score was an independent prognostic indicator for HCC patients who underwent TACE, and it was superior to the other inflammation-based scores in prognostic ability.


HCC: hepatocellular carcinoma; TACE: transarterial chemoembolization; GPS: Glasgow Prognostic Score; mGPS: modified Glasgow Prognostic Score; Hs-mGPS: high-sensitivity modified Glasgow Prognostic Score; NLR: neutrophil-to-lymphocyte ratio; PLR: platelet-to-lymphocyte ratio; PNI: Prognostic nutritional index; SII score: systemic immune-inflammation index; LCR: lymphocyte-to-C-reactive protein ratio; CRP: C-reactive protein; AFP: alpha-fetoprotein; ALBI grade: albumin-bilirubin grade; BCLC stage: Barcelona Clinic Liver Cancer stage; OS: overall survival.