Prognostic value of pre-operative inflammatory response biomarkers in gastric cancer patients and the construction of a predictive model.
Prognostic value of pre-operative inflammatory response biomarkers in gastric cancer patients and the construction of a predictive model.
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胃癌患者术前炎症反应生物标志物的预后价值及预测模型的构建。
DOI：
10.1186/s12967-015-0409-0
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发表时间：
2015-02-18
影响因子：
7.4
通讯作者：
Wang S
中科院分区：
文献类型：
--
作者：
Deng Q;He B;Liu X;Yue J;Ying H;Pan Y;Sun H;Chen J;Wang F;Gao T;Zhang L;Wang S
炎症在癌发生和肿瘤进展中起着不可或缺的作用。炎症反应生物标志物已被证明是提高各种癌症预测准确性的有希望的预后因素。本研究旨在探讨胃癌患者术前中性粒细胞/淋巴细胞比值（NLR）、衍生中性粒细胞/淋巴细胞比值（dNLR）、血小板/淋巴细胞比值（PLR）和淋巴细胞/单核细胞比值（LMR）的预后意义。本研究从2007年至2009年入组了389例接受胃切除术的患者。根据术前外周血细胞计数计算NLR、dNLR、PLR和LMR。使用受试者工作曲线（ROC）来确定这些生物标志物的最佳截止水平。建立肿瘤特异性生存期（CSS）和无病生存期（DFS）的预测模型或诺模图，用一致性指数（c-index）判断诺模图的预测准确性。中位随访期为24个月，范围为3个月至60个月。经ROC曲线分析，NLR、dNLR、PLR和LMR的最佳截断值分别为2.36、1.85、132和4.95。NLR、dNLR和PLR升高与总生存期（OS）、CSS和DFS显著相关，而LMR升高对OS、CSS和DFS有不良影响。多因素分析显示，dNLR升高是OS恶化的独立因素，NLR的风险比（HR = 1.53，95% CI = 1.11-2.11，P = 0.010）优于dNLR、PLR和LMR（上级），是CSS和DFS的独立预后指标。此外，诺模图可以更准确地预测手术GC患者的CSS（c指数：0.89）和DFS（c指数：0.84）。术前NLR和dNLR可作为接受手术切除的GC患者的潜在预后生物标志物。建议的诺模图可用于预测CSS和DFS的胃癌患者进行了胃切除术。
Inflammation plays an integral role in carcinogenesis and tumor progression. Inflammatory response biomarkers have shown to be promising prognostic factors for improving the predictive accuracy in various cancers. The aim of this study is to investigate the prognostic significance of pre-operative neutrophil to lymphocyte ratio (NLR), derived neutrophil to lymphocyte ratio (dNLR), platelet to lymphocyte ratio (PLR) and lymphocyte to monocyte ratio (LMR) in gastric cancer (GC). 389 patients who had undergone gastrectomy were enrolled from 2007 to 2009 in this study. NLR, dNLR, PLR and LMR were calculated from peripheral blood cell count taken at pre-operation. Receiver operating curve (ROC) was used to determine the optimal cut-off levels for these biomarkers. A predictive model or nomogram was established to predict prognosis for cancer-specific survival (CSS) and disease-free survival (DFS), and the predictive accuracy of the nomogram was determined by concordance index (c-index). The median follow-up period was 24 months ranging from 3 months to 60 months. The optimal cut-off levels were 2.36 for NLR, 1.85 for dNLR, 132 for PLR and 4.95 for LMR by ROC curves analysis. Elevated NLR, dNLR and PLR were significantly associated with worse overall survival (OS), CSS and DFS, however, elevated LMR showed an adverse effect on worse OS, CSS and DFS. Multivariate analysis revealed that elevated dNLR was an independent factor for worse OS, and NLR was superior to dNLR, PLR and LMR in terms of hazard ratio (HR = 1.53, 95% CI = 1.11-2.11, P = 0.010), which was shown to be independent prognostic indicators for both CSS and DFS. Moreover, the nomogram could more accurately predict CSS (c-index: 0.89) and DFS (c-index: 0.84) in surgical GC patients. Pre-operative NLR and dNLR may serve as potential prognostic biomarkers in patients with GC who underwent surgical resection. The proposed nomograms can be used for the prediction of CSS and DFS in patients with GC who have undergone gastrectomy.
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影响因子：
8.8
作者：
Dalpiaz, O.;Pichler, M.;Mannweiler, S.;Hernandez, J. M. Martin;Stojakovic, T.;Pummer, K.;Zigeuner, R.;Hutterer, G. C.
通讯作者：
Hutterer, G. C.
影响因子：
45.3
作者：
Bochner, Bernard H.;Dalbagni, Guido;Kikuchi, Eiji
通讯作者：
Kikuchi, Eiji
影响因子：
7.4
作者：
Cho, In Rae;Park, Jun Chul;Lee, Yong Chan
通讯作者：
Lee, Yong Chan
影响因子：
3
作者：
Dutta, Sumanta;Crumley, Andrew B. C.;McMillan, Donald C.
通讯作者：
McMillan, Donald C.
影响因子：
45.3
作者：
Karakiewicz, Pierre I.;Briganti, Alberto;Patard, Jean-Jacques
通讯作者：
Patard, Jean-Jacques