2020 Volume 61 Issue 11 Pages 552-563
Liver cirrhosis (LC) presents with a variety of immunological abnormalities and is associated with a decrease in lymphocytes. Recently, immunodeficiency and immunodeficiency-induced bacterial infection and inflammation in LC have been labeled cirrhosis-associated immune dysfunction (CAID), and have attracted much attention, as they are associated with worsening of liver disease. In this study, we investigated total lymphocyte counts (TLC) in 274 cases of LC. In addition, we developed a stage classification for CAID diagnosis based on the neutrophil fraction (%) of leukocytes and TLC. The results of multivariate analysis revealed that leukocyte count, splenomegaly, hepatocellular carcinoma, and neutrophilia were factors contributing to the decrease in TLC, and TLC were independent prognostic factors of LC. CAID staging significantly stratified the survival rate of LC. Immunodeficiency of LC contributed to CAID-induced worsening of liver disease as a trigger of inflammation, indicating the usefulness of staging by hemogram.