Preoperative neutrophil-lymphocyte ratio combined with the serum ALB concentration to predict the need for perioperative blood transfusion in patients with hepatocellular carcinoma
10.13303/j.cjbt.issn.1004-549x.2026.09.014
- VernacularTitle:中性粒细胞/淋巴细胞比值联合血清白蛋白对肝细胞癌患者围术期红细胞输注的预测价值
- Author:
Jun ZHANG
1
;
Qingmei GAO
1
;
Xinfang ZHU
1
;
Rong XIA
1
;
Qi ZHANG
1
Author Information
1. Department of Blood Transfusion, Huashan Hospital, Fudan University, Shanghai 200000, China
- Publication Type:Journal Article
- Keywords:
neutrophil-to-lymphocyte ratio;
serum albumin;
transfusion;
inflammation;
hepatocellular carcinoma
- From:
Chinese Journal of Blood Transfusion
2026;39(9):1262-1268
- CountryChina
- Language:Chinese
-
Abstract:
Objective: To investigate the predictive value of preoperative Neutrophil-to-Lymphocyte Ratio (NLR), serum albumin (ALB), and their combination for perioperative RBC transfusion in patients with hepatocellular carcinoma. Methods: A total of 1 027 patients clinically diagnosed with hepatocellular carcinoma who underwent radical surgery were retrospectively analyzed. The patients were divided into transfusion group and non-transfusion group according to whether they received red blood cell suspension transfusion. The perioperative clinical data of patients were compared between the groups. The predictive value of NLR combined with ALB for perioperative blood transfusion was analyzed by receiver operating characteristic (ROC) curve, and the optimal cutoff value was determined. Results: A total of 207 patients (20.16%, 207/1 027) received RBC transfusion. NLR combined with serum ALB concentration (ROC=0.712; P<0.001) was more accurate in predicting transfusion demand than NLR or ALB alone. The transfusion rate in the group with NLR>2.12 and ALB≤40.5 (45.32%, 92/203) was significantly higher than that in the group with NLR≤2.12 and ALB>40.5 (13.01%, 51/392) and the remaining combination group (14.81%, 64/432). Correlation analysis showed that NLR was statistically significantly correlated with ASA score, vascular invasion, satellite data, and the extent of liver resection. ALB was significantly correlated with ASA score, TNM stage, vascular invasion, satellite, and extent of hepatectomy. Conclusion: This study demonstrates that the combination of preoperative inflammatory factor NLR and serum ALB can effectively predict the perioperative blood transfusion needs of patients with hepatocellular carcinoma.
