Elevated Preoperative Neutrophil to Lymphocyte Ratio Predicts Poor Survival Following Resection in Late Stage Gastric Cancer
Elevated Preoperative Neutrophil to Lymphocyte Ratio Predicts Poor Survival Following Resection in Late Stage Gastric Cancer
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DOI：
10.1002/jso.21986
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发表时间：
2011-10-01
影响因子：
2.5
通讯作者：
Kim, Young Jin
中科院分区：
文献类型：
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作者：
Jung, Mi Ran;Park, Young Kyu;Kim, Young Jin
背景：中性粒细胞与淋巴细胞比值（N/L比值）升高已被证明是多种癌症的预后指标。我们旨在探讨术前N/L比值对晚期胃癌的预后意义。方法：2004年4月至2007年8月，293例以AJCC/UICC TNM为治疗目的行胃切除术的III期或IV期胃癌患者。N/L比值由术前常规血液检查的淋巴细胞和中性粒细胞计数计算。结果：存活患者的中位随访时间为38.2个月（4.2 ~ 65.5个月），中位术前N/L比为2.06（0.47 ~ 19.73）。在N/L值为2.0时对受试者进行二分类。多因素分析证实N/L比与总生存率之间存在显著相关性（HR = 1.609； 95%可信区间CI， 1.144-2.264; P = 0.006）。截止值3.0，即75个百分位值，对无病生存有显著的预后影响（HR = 1.654; 95% CI, 1.088 ~ 2.515; P = 0.019）。结论：研究结果表明，术前N/L比值升高预示着晚期胃癌切除术后的无病生存期和总生存期较差。它可以作为一种简单、可靠的风险分层预后因素，并将提供更好的治疗分配。中华外科杂志。2011；104:504 - 510。(C) 2011 Wiley-Liss, Inc。
Background: Elevated neutrophil to lymphocyte ratio (N/L ratio) has been shown to be a prognostic indicator in various cancers. We aimed to investigate the prognostic significance of the preoperative N/L ratio in late stage gastric cancer.Methods: From April 2004 to August 2007, 293 patients who had undergone gastrectomy with curative intent for the AJCC/UICC TNM Stage III or IV gastric cancer were included. N/L ratio was calculated from lymphocyte and neutrophil counts on routine blood tests taken prior to surgery.Results: The median follow-up time for surviving patients was 38.2 months (4.2-65.5 months) and median preoperative N/L ratio was 2.06 (range 0.47-19.73). Subjects were dichotomized at the N/L value of 2.0. A multivariate analysis established a significant relationship between the N/L ratio and overall survival (HR = 1.609; 95% confidence interval, CI, 1.144-2.264; P = 0.006). The cutoff value up to 3.0, the value of 75 percentiles, showed a significant prognostic effect on disease-free survival (HR = 1.654; 95% CI, 1.088-2.515; P = 0.019).Conclusions: The results suggest that the elevated preoperative N/L ratio predicts poor disease-free and overall survival following resection for late stage gastric cancer. It may be utilized as a simple, reliable prognostic factor for risk stratification and will provide better treatment allocation. J. Surg. Oncol. 2011; 104:504-510. (C) 2011 Wiley-Liss, Inc.