To investigate the relationship between preoperative C-reactive protein-albumin-lymphocyte ratio (CALLY index) and prognosis in patients with hepatocellular carcinoma (HCC).

A retrospective analysis of clinical data of 122 HCC patients who underwent radical surgery at the First Affiliated Hospital of Bengbu Medical College from January 2016 to January 2019 was carried out. Receiver operating characteristic (ROC) curves of preoperative CALLY index were drawn to determine the optimal cut-off value of preoperative CALLY index. The clinical and pathological characteristics of HCC patients with high and low levels of preoperative CALLY index were compared, and the risk factors affecting the prognosis of HCC patients were analyzed.

Referring to the final survival status of the patients, the optimal cut-off value for preoperative CALLY index was 5.495, the area under the curve was 0.753 (95% CI: 0.666-0.841), the sensitivity was 0.709 and the specificity was 0.761. The preoperative peripheral blood CALLY index was associated with clinical and pathological factors such as vascular invasion and BCLC staging (P<0.05). The survival prognostic curve showed that the 1-, 3-, and 5-year overall survival rates (70.15%, 44.78%, and 23.88%) of patients in the low-level preoperative CALLY index group were significantly lower than those in the high-level group (94.55%, 78.18%, 70.91%), so did the comparison results of the 1-, 3-, and 5-year tumor-free survival rates (65.67% vs 90.91%, 49.25% vs 65.45%, 14.93% vs 34.55%, respectively). The differences were statistically significant (P<0.001). The results of multivariate Cox analysis showed that BCLC staging (HR=3.696, 95% CI: 2.229-6.127, P<0.001), presence of MVI (HR=2.785, 95% CI: 1.691-4.588, P<0.001), and preoperative CALLY index (HR=0.272, 95% CI: 0.153-0.484, P<0.001) were all significantly associated with overall survival.

Preoperative CALLY index has the potential to become a biomarker for predicting the prognosis of HCC patients.