Abstract: Objective To investigate the predictive value of preoperative serum lymphocyte count to C-reactive protein (CRP) ratio (LCR) and forkhead box protein A1 (FOXA1) for prognosis in patients with primary liver cancer after transcatheter arterial chemoembolization (TACE).Methods From June 2021 to June 2022,107 primary liver cancer patients who underwent TACE surgery and 107 primary liver cancer patients who did not undergo TACE surgery were selected as the observation group and control group in our hospital.The observation group was assigned into a survival group and a death group based on the 2-year survival status.Record the preoperative lymphocyte count and serum CRP,and LCR was calculated.Enzyme linked immunosorbent assay was applied to detect preoperative serum FOXA1 level.Kaplan-Meier survival curve was applied to analyze the relationship between LCR,FOXA1,and the two-year survival rate of patients after TACE surgery.ROC curve was plotted to analyze the predictive value of preoperative serum LCR and FOXA1 for the prognosis of patients after TACE.Multivariate Cox regression was applied to analyze the influencing factors of postoperative prognosis.Results There was no statistically significant difference in baseline data,preoperative lymphocyte count,CRP,LCR,and FOXA1 levels between the observation group and the control group (P>0.05).Patients with high preoperative LCR had a higher 2-year survival rate than those with low LCR,while patients with high FOXA1 had a lower 2-year survival rate than those with low FOXA1 (P<0.05).The area under the curve (AUC) of the combination of preoperative LCR,and FOXA1 in predicting the prognosis of primary liver cancer patients after TACE was higher than that predicted by preoperative LCR and FOXA1 alone (Z=4.313,3.500,P<0.05).Clinical TNM stage Ⅲ,tumor number ≥ 2,preoperative serum CRP and FOXA1 level were risk factors for postoperative prognosis in patients with primary liver cancer undergoing TACE,while preoperative lymphocyte count and LCR were protective factors for postoperative prognosis (P<0.05).Conclusion Preoperative LCR is lower and FOXA1 level is higher in patients who died after TACE for primary liver cancer.Preoperative LCR and FOXA1 levels are closely related to the postoperative prognosis of TACE for primary liver cancer.

Key words: primary liver cancer; lymphocyte count to C-reactive protein ratio; forkhead box protein A1; transcatheter arterial chemoembolization; prognosis