Pre-treatment neutrophil to lymphocyte ratio as a prognostic marker to predict chemotherapeutic response and survival outcomes in metastatic advanced gastric cancer
Pre-treatment neutrophil to lymphocyte ratio as a prognostic marker to predict chemotherapeutic response and survival outcomes in metastatic advanced gastric cancer
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DOI：
10.1007/s10120-013-0330-2
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发表时间：
2014-10-01
期刊：
影响因子：
7.4
通讯作者：
Lee, Yong Chan
中科院分区：
文献类型：
--
作者：
Cho, In Rae;Park, Jun Chul;Lee, Yong Chan
一些研究表明，外周血中的中性粒细胞与淋巴细胞比率（NLR）是各种癌症的预后因素。然而，关于NLR在转移性进展期胃癌（AGC）患者中的临床和预后意义的信息有限。因此，我们研究NLR是否可以作为一个预后指标来预测接受姑息化疗的转移性AGC患者的化疗反应和生存结局。根据首次化疗前采集的全血细胞计数计算NLR。根据NLR的中位数将患者分为高NLR组和低NLR组，中位随访时间为340天（范围72-1796天），中位NLR为3.06（范围0.18-18.16）。高NLR组（NLR > 3.0）138例，低NLR组（NLR <3.0）130例。与高NLR组患者相比，低NLR组患者的化疗疾病控制率显著更高（90.0% vs. 80.4; P = 0.028），无进展生存期（PFS）和总生存期（OS）更长（分别为186 vs. 146天; P = 0.001; 414 vs. 280天; P < 0.001）。多因素分析显示NLR与PFS（HR 1.478; 95% CI 1.154-1.892; P = 0.002）和OS（HR 1.569; 95% CI 1.227-2.006; P < 0.001）显著相关，治疗前NLR是接受姑息化疗的转移性AGC患者的一个有用的预后指标。
Several studies have shown that the neutrophil to lymphocyte ratio (NLR) in peripheral blood is a prognostic factor of various cancers. However, there is limited information on the clinical and prognostic significance of NLR in patients with metastatic advanced gastric cancer (AGC). Therefore, we examined whether the NLR can be used as a prognostic marker for predicting chemotherapeutic response and survival outcomes in metastatic AGC patients who are receiving palliative chemotherapy.A total of 268 patients diagnosed with metastatic AGC were enrolled. NLR was calculated from complete blood cell count taken before the first chemotherapy treatment. Patients were divided into two groups according to the median value of NLR: a high NLR group and a low NLR group.The median follow-up period was 340 days (range 72-1796 days) and median NLR was 3.06 (range 0.18-18.16). The high NLR group (NLR > 3.0) contained 138 patients and the low NLR group (NLR a parts per thousand currency sign3.0) contained 130 patients. Low NLR group patients had a significantly higher chemotherapeutic disease control rate (90.0 % vs. 80.4; P = 0.028), and longer progression-free survival (PFS) and overall survival (OS) than the high NLR group patients (186 vs. 146 days; P = 0.001; 414 vs. 280 days; P < 0.001, respectively). In multivariate analysis, NLR showed a significant association with PFS (HR 1.478; 95 % CI 1.154-1.892; P = 0.002) and OS (HR 1.569; 95 % CI 1.227-2.006; P < 0.001).Pretreatment NLR is a useful prognostic marker in patients with metastatic AGC who are undergoing palliative chemotherapy.