The combination of TLSs and the neutrophil-to- monocyte ratio predicts early recurrence in patients with hepatocellular carcinoma

Abstract

Liver cancer, primarily hepatocellular carcinoma (HCC), is one of the deadliest cancers globally. However, effective predictive models for early recurrence and poor prognosis in HCC remain limited. This retrospective study analyzed 180 patients with HCC to explore the prognostic value of tertiary lymphoid structures (TLSs), peripheral blood immune parameters, and clinical factors. The findings revealed that TLSs significantly reduced early recurrence rates, although they were not associated with late recurrence. The interaction of peripheral blood immune parameters, particularly the neutrophil–monocyte ratio (NMR), was found to play a crucial role in predicting early recurrence. A novel clinical prediction model was developed by integrating the tumor-node-metastasis (TNM) staging system (8th edition), TLS status, and NMR data. This model demonstrated strong predictive accuracy for early HCC recurrence. These results underscore the multifaceted influence of TLSs and peripheral blood immunity on HCC prognosis. The proposed model offers a valuable tool for personalized patient management, particularly in identifying the risk of early recurrence.