Prognostic value of simple inflammation based markers in hepatocellular carcinoma

Despite recent progression in cancer diagnosis and treatment, hepatocellular carcinoma (HCC) remains a destructive disease with a dismal prognosis. As a hallmark of cancer, tumor-associated systemic inflammation and tumor inflammatory microenvironment play significant roles in cancer development and progression. HCC represents a typical instance of inflammation-related cancer since most HCC cases arise from chronic liver injury and inflammation. Based on this theory, a number of simple inflammation-based markers are established to reflect inflammation status and more importantly, to predict the prognosis of HCC patients. Among the reported markers, serum C-reactive protein (CRP) level, Glasgow prognostic score (GPS), modified Glasgow prognostic score (mGPS), prognositc index (PI), prognostic nutritional index (PNI), neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR) are intensively investigated and showed significant prognostic value in HCC patients receiving various treatments. Several other novel prognostic markers were also innovated to link inflammation and HCC prognosis. Based on routine laboratory tests, these inflammation-based prognostic markers may help improve the dilemma of HCC clinical management through enabling risk stratification, personalized surveillance and active intervention against this deadly disease. The purpose of this review is to summarize and discuss current knowledge on the prognostic value of simple inflammation based markers in HCC and to provide perspectives for future investigation.