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

Abstract

Abstract Introduction: Liver cancer, predominantly hepatocellular carcinoma (HCC), ranks among the deadliest malignancies worldwide, and effective predictive models for early recurrence and poor prognosis are limited. Methods This study retrospectively analyzed 180 HCC patients and explored the prognostic value of tertiary lymphoid structures (TLSs), peripheral blood immune parameters, and clinical factors in HCC. Results The results showed that TLSs could significantly reduce early recurrence rates but that they were not related to late recurrence. The interaction of peripheral blood immune parameters, especially the neutrophil–monocyte ratio (NMR), plays a pivotal role in early recurrence prediction. A novel clinical prediction model was constructed by combining the tumor-node-metastasis (TNM) staging system (8th edition), TLS status, and NMR data, and the results demonstrated substantial predictive accuracy for early HCC recurrence. Conclusions These findings highlight the multifaceted impact of TLSs and peripheral blood immunity on HCC prognosis and provide a valuable tool for personalized patient management, particularly for identifying early recurrence risk.