The neutrophil-to-lymphocyte ratio (NLR) predicts short-term and long-term outcomes in gastric cancer patients
The neutrophil-to-lymphocyte ratio (NLR) predicts short-term and long-term outcomes in gastric cancer patients
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DOI：
10.1016/j.ejso.2018.02.003
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发表时间：
2018-05-01
期刊：
影响因子：
3.8
通讯作者：
Yamamoto, Masayoshi
中科院分区：
文献类型：
--
作者：
Miyamoto, Ryoichi;Inagawa, Satoshi;Yamamoto, Masayoshi
背景：术前中性粒细胞与淋巴细胞比值（NLR）是胃癌患者的一个众所周知的预后指标。然而，NLR在预测胃癌患者短期预后方面的应用尚不清楚。在这里，我们研究了术前NLR是否是胃癌患者短期预后的预测因子。方法：对154例连续胃癌患者进行回顾性评价。我们比较了围手术期结果和中位生存时间（MSTs）。特别是，对于分期（UICC，第7版）胃癌患者，我们比较了低nlr组和高nlr组的中位无病生存时间（MDFST）。结果：低nlr组（n = 110）与高nlr组（n = 44）围手术期预后差异显著，包括术后并发症(3例（2.7%）vs. 5例（11.3%）；P = 0.015)、术中失血量（158 +/- 168 g对232 +/- 433 g， P = 0.022）、术中输血量(0比3 (6.8%)；P = 0.042)。MSTs和MDFSTs也有显著差异（812天vs. 594天，p = 0.04； 848天vs. 475天，p = 0.03）。多因素分析发现，NLR（风险比为2.015,p = 0.004）、格拉斯哥预后评分（GPS）（风险比为1.533,p = 0.012）、III/IV期疾病（风险比为5.488,p < 0.001）、术前症状（风险比为3.412,p = 0.008）或术后并发症（风险比为2.698,p < 0.001）是独立的预后因素。结论：我们认为术前NLR是胃癌患者长期和短期预后的一个额外有用的预测指标。(C) 2018爱思唯尔有限公司，BASO类似于癌症外科协会和欧洲外科肿瘤学会。版权所有。
Background: The preoperative neutrophil-to-lymphocyte ratio (NLR) is a well-known prognostic marker for gastric cancer patients. However, the utility of the NLR in predicting short-term outcomes in gastric cancer patients remains unclear. Here, we investigated whether the preoperative NLR is a predictor of short-term outcomes in gastric cancer patients.Methods: We retrospectively evaluated 154 consecutive gastric cancer patients. We compared the perioperative outcomes and median survival times (MSTs). In particular, for stage (UICC, 7th edition) gastric cancer patients, we compared median disease-free survival time (MDFST) between the low- and high-NLR groups.Results: Between the low-NLR group (n = 110) and the high-NLR group (n = 44), significant differences were observed in perioperative outcomes, including postoperative complications (3 (2.7%) vs. 5 (11.3%); p = 0.015), intraoperative blood loss (158 +/- 168 g vs. 232 +/- 433 g; p = 0.022), and intraoperative blood transfusions (0 vs. 3 (6.8%); p = 0.042). MSTs and MDFSTs were also significantly different (812 vs. 594 days, p = 0.04; and 848 vs. 475 days, p = 0.03, respectively). Multivariate analysis identified the NLR (hazard ratio pin 2.015; p = 0.004), Glasgow Prognostic Score (GPS) (HR, 1.533; p = 0.012), and presence of stage III/IV disease (HR, 5.488; p < 0.001), preoperative symptoms (HR, 3.412; p = 0.008), or postoperative complications (HR, 2.698; p < 0.001) as independent prognostic factors.Conclusions: We suggest that the preoperative NLR is an additional useful predictor of both long-term and short-term outcomes in gastric cancer patients. (C) 2018 Elsevier Ltd, BASO similar to The Association for Cancer Surgery, and the European Society of Surgical Oncology. All rights reserved.