Predictive value of preoperative peripheral blood SII, PLR and NLR for lymph node metastasis in patients with gastric cancer
10.3760/cma.j.cn115355-20240221-00080
- VernacularTitle:胃癌患者术前外周血SII、PLR和NLR对淋巴结转移的预测价值
- Author:
Yurong ZHU
1
;
Jintian LI
Author Information
1. 江苏省肿瘤医院 南京医科大学附属肿瘤医院 江苏省肿瘤防治研究所检验科，南京 210009
- Keywords:
Stomach neoplasms;
Systemic immune-inflammation index;
Neutrophil-to-lymphocyte ratio;
Platelet-to-lymphocyte ratio;
Lymph node metastasis;
Predictive mode
- From:
Cancer Research and Clinic
2024;36(11):829-834
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the predictive value of preoperative peripheral blood systemic immune-inflammation index (SII), platelet-to-lymphocyte ratio (PLR) and neutrophil-to-lymphocyte ratio (NLR) for lymph node metastasis in gastric cancer patients.Methods:A retrospective case cohort study was performed. The clinicopathological data of 319 gastric cancer patients who underwent surgical resection in Jiangsu Cancer Hospital from October 2021 to December 2022 were retrospectively analyzed. Among them, 150 cases were postoperatively pathologically confirmed as non-lymph node (non-metastasis group) and 169 cases were confirmed as lymph node (metastasis group). Preoperative SII, PLR, and NLR of patients in both groups were compared. The receiver operating characteristic (ROC) curve was drawn and the area under the curve (AUC) was calculated to determine the optimal cut-off value of all hematological indicators to judge lymph node metastasis. Logistic regression was used to analyze the factors influencing the lymph node metastasis of gastric cancer. According to multivariate logistic regression result, the predictive model for lymph node metastasis in gastric cancer was established. R4.2.1 software was used to establish a nomogram model. C statistics and Hosmer-Lemeshow test were used to evaluate the predictive performance and the fitness of the model.Results:Among 150 non-metastatic patients, 105 cases were male and 45 cases were female, the age [ M ( Q1, Q3)] was 60 years (54 years, 70 years); among 169 metastatic patients, 124 cases were male and 45 cases were female, the age was 64 years (56 years, 70 years). Compared with non-metastasis group, patients in metastasis group had higher levels of preoperative SII, PLR and NLR, and the differences were statistically significant ( Z = -4.58, -4.14, -3.79, all P < 0.05). The AUC values of SII, PLR, and NLR were 0.649, 0.634 and 0.623, respectively, with optimal cut-off values of 710.24, 182.21 and 1.72. Multivariate logistic analysis showed that SII > 710.24 ( OR = 2.051, 95% CI: 1.006-4.184, P = 0.048), PLR > 182.21 ( OR = 1.950, 95% CI: 1.011-3.760, P = 0.046), NLR > 1.72 ( OR =1.976, 95% CI: 1.116-3.500, P = 0.020), carcinoembryonic antigen (CEA) > 2.57 ng/ml ( OR =2.179, 95% CI: 1.290-3.679, P = 0.004), carbohydrate antigen 724 (CA724) > 1.83 U/ml ( OR =2.365, 95% CI: 1.420-3.938, P = 0.001), and carbohydrate antigen 199 (CA199) > 14.85 U/ml ( OR =1.965, 95% CI: 1.129-3.420, P = 0.017) were independent risk factors for lymph node metastasis in gastric cancer. The predictive model of gastric cancer patients with lymph node metastasis: logit (P) = -1.730+0.718×SII+0.668×PLR+0.681×NLR+0.779×CEA+0.861×CA724+0.676×CA199. The prediction accuracy rate was 71.47% and C statistics was 0.762 (95% CI: 0.710-0.815, P < 0.01). There was no statistically significant difference between the model predictive value and the actual observed value ( χ2 = 3.84, P = 0.871). Conclusions:Preoperative monitoring of peripheral blood SII, PLR and NLR levels has a certain value in predicting lymph node metastasis in patients with gastric cancer.
