Does neutrophil to lymphocyte ratio have a role in identifying cytokeratin 19-expressing hepatocellular carcinoma?

Chao Wei Lee, Sey En Lin, Ming Chin Yu, Hao Wei Kou, Cheng Han Lee, Tony Kuo, Kuan Chieh Lee, Hsin I. Tsai

Research output: Contribution to journalArticlepeer-review

1 Citation (Scopus)


Background: Cytokeratin 19-positive (CK19(+)) hepatocellular carcinomas (HCC) are generally associated with poor prognosis after hepatectomy. It is typically detected from postoperative immunochemistry. We have analyzed several clinically available biomarkers, in particular, neutrophil to lymphocyte ratio (NLR) and aim to develop a panel of biomarkers in identifying CK19 expression in (HCC) preoperatively. Methods: We retrospectively reviewed 36 HCC patients who underwent liver resections during January 2017 to March 2018 in Chang Gung Memorial Hospital. Patients were grouped based on the status of CK19 expression and their baseline characteristics, perioperative and oncologic outcomes were compared. Novel biomarkers including NLR, alpha-fetoprotein (AFP), carcinoembryonic antigen (CEA) and uric acid were analyzed and correlated with CK19 expression. Results: NLR is highly associated with CK19 expression. NLR alone gave an AUROC of 0.728 (p-value = 0.043), higher than AFP, CEA or tumor size alone. NLR when combined with AFP, CEA and uric acid, gave an AUROC as high as 0.933 (p-value = 0.004). Conclusion: The current study demonstrated the predictive capability of NLR in combination with AFP, CEA and uric acid for CK19 expression in HCC patients preoperatively. Further prospective, large-scale studies are warranted to validate our findings.

Original languageEnglish
Article number1078
JournalJournal of Personalized Medicine
Issue number11
Publication statusPublished - Nov 2021
Externally publishedYes


  • Cytokeratin 19 (CK19)
  • Hepatocellular carcinoma
  • Hepatoma
  • Neutrophil to lymphocyte ratio
  • NLR

ASJC Scopus subject areas

  • Medicine (miscellaneous)


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