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Background: Hepatocellular Carcinoma (HCC), hepatitis B, hepatitis C, chronic alcoholism, non-alcoholic fatty liver disease, copper and iron deposition etiologies, together with various genetic factors, constitute a rather complex cancer group that includes chronic inflammation, chronic systemic inflammation triggered by oxidative stress. Therefore, an increase in the incidence and prevalence of liver cancer is expected in the future. Discovery of new biomarkers in HCC diagnosis, prognosis, prediction of treatment response and treatment follow-up is very important. The aim of our study was to retrospectively evaluate the clinical significance of the Red blood cell Distribution Width (RDW) to lymphocyte ratio (RLR) in patients with chronic liver disease with HCC.  Materials and methods: Our study, which was designed retrospectively, included 200 patients who were followed up with the diagnosis of HCC. Liver function tests, hematological parameters, biochemical tests were analyzed in Çukurova University Balcalı hospital. Child Pugh Score (CTP) and RLR of the patients were calculated with the necessary equations. HCC patients were analyzed in two groups as alfa feto protein (AFP) negative ( 20 ng/ml). All the obtained results were analyzed in SPSS program.  Results: A total of 200 patients with HCC were included in this study. Half of the 200 HCC patients included in the study were found to be AFP negative, and the gender distribution in this group was found to be 24.2% for women and 75.8% for men. A significant increase in the rate of RLR was detected in the AFP positive group (AFP negative 13.54 ± 9.67, AFP positive 20.11 ± 27.38, and p value 0.03). According to Child Pugh score, RLR rates were found to be 11.72 ± 8.82 in CTP A, 15.96 ± 8.78 in CTP B, 27.47 ± 35.6 in CTP C, p value &lt;0.001. In multivariate logistic regression analysis according to AFP group distribution, the OR value of RLR was determined as 0.95, 95% CI (0.90-1.00) and p value was 0.02.  Conclusion: We think that RLR can be used as a new biomarker associated with poor prognosis in AFP positive HCC patients.

Red cell distribution width to lymphocyte ratio as a new biomarker in predicting prognosis in chronic liver disease patients with hepatocellular carcinoma