Preoperative neutrophil-to-lymphocyte ratio plusplatelet-to-lymphocyte ratio inpredicting survival forpatients withstage I-II gastric cancer
10.1186/s40880-016-0122-2
- Author:
XiaoweiSun
1
;
XuechaoLiu
;
JianjunLiu
;
ShangxiangChen
;
DazhiXu
;
WeiLi
;
YouqingZhan
;
YuanfangLi
;
YingboChen
;
ZhiweiZhou
Author Information
1. Department ofGastric andPancreatic Surgery
- Keywords:
Neutrophil-to-lymphocyte ratio;
Platelet-to-lymphocyte ratio;
Prognosis;
Gastric cancer
- From:Chinese Journal of Cancer
2016;35(7):359-365
- CountryChina
- Language:Chinese
-
Abstract:
Background:The preoperative neutrophil-to-lymphocyte ratio (NLR) and the platelet-to-lymphocyte ratio (PLR) are associated with poor prognosis of gastric cancer. We aimed to determine whether the combination of NLR and PLR (NLR–PLR) could better predict survival of patients after curative resection for stage I–II gastric cancer.
Methods:We collected data from the medical records of patients with stage I–II gastric cancer undergoing curative resection between December 2000 and November 2012 at the Sun Yat-sen Cancer Center. The preoperative NLR–PLR was calculated as follows: patients with both elevated NLR (≥2.1) and PLR (≥120) were given a score of 2, and patients with only one or neither were given a score of 1 or 0, respectively.
Results:Kaplan–Meier analysis and log-rank tests revealed signiifcant differences in overall survival (OS) among patients with NLR–PLR scores of 0, 1 and 2 (P<0.001). Multivariate analysis showed that OS was independently associated with the NLR–PLR score [hazard ratio (HR)=1.51, 95% conifdence interval (CI)1.02–2.24,P=0.039] and TNM stage (HR=1.36, 95% CI1.01–1.83,P=0.041). However, other systemic inlfammation-based prognostic scores, including the modiifed Glasgow prognostic score, the prognostic nutritional index, and the combination of platelet count and NLR, were not. In TNM stage-stratiifed analysis, the prognostic signiifcance of NLR–PLR was maintained in patients with stage I (P<0.001) and stage II cancers (P=0.022). In addition, the area under the receiver operating characteristic curve for the NLR–PLR score was higher than those of other systemic inlfammation-based prognostic scores (P=0.001).
Conclusion:The preoperative NLR-PLR score is a useful predictor of postoperative survival in the patients with stage I–II gastric cancer and may help identify high-risk patients for rational therapy and timely follow-up.
