Sun Jingxu, Chen Xiaowan, Gao Peng, Song Yongxi, Huang Xuanzhang, Yang Yuchong, Zhao Junhua, Ma Bin, Gao Xinghua, Wang Zhenning
Department of Surgical Oncology and General Surgery, First Hospital of China Medical University, Shenyang 110001, China.
Department of Dermatology, First Hospital of China Medical University, Shenyang 110001, China.
Dis Markers. 2016;2016:7862469. doi: 10.1155/2016/7862469. Epub 2016 Jan 26.
The prognostic role of neutrophil to lymphocyte ratio (NLR) in gastric cancer remains controversial. We aimed to quantify the prognostic role of peripheral blood NLR in gastric cancer. A literature search was conducted in PubMed, EMBASE, and Cochrane databases. The results for overall survival (OS) and progression-free survival (PFS)/disease-free survival (DFS) are expressed as hazard ratios (HRs) with 95% confidence intervals (CIs). 19 studies with 5431 patients were eligible for final analysis. Elevated NLRs were associated with a significantly poor outcome for OS (HR = 1.98; 95% CI: 1.75-2.24, p < 0.001) and PFS (HR = 1.58; 95% CI: 1.32-1.88, p < 0.001) compared with patients who had normal NLRs. The NLR was higher for patients with late-stage compared with early-stage gastric cancer (OR = 2.76; 95% CI: 1.36-5.61, p = 0.005). NLR lost its predictive role for patients with stage IV gastric cancer who received palliative surgery (HR = 1.73; 95% CI: 0.85-3.54, p = 0.13). Our results also indicated that prognoses might be influenced by the NLR cutoff values. In conclusion, elevated pretreatment NLRs are associated with poor outcome for patients with gastric cancer. The ability to use the NLR to evaluate the status of patients may be used in the future for personalized cancer care.
中性粒细胞与淋巴细胞比值（NLR）在胃癌中的预后作用仍存在争议。我们旨在量化外周血NLR在胃癌中的预后作用。在PubMed、EMBASE和Cochrane数据库中进行了文献检索。总生存期（OS）和无进展生存期（PFS）/无病生存期（DFS）的结果以风险比（HR）及95%置信区间（CI）表示。19项研究共5431例患者符合最终分析标准。与NLR正常的患者相比，NLR升高与OS（HR = 1.98；95%CI：1.75 - 2.24，p < 0.001）和PFS（HR = 1.58；95%CI：1.32 - 1.88，p < 0.001）显著较差的结局相关。与早期胃癌患者相比，晚期胃癌患者的NLR更高（OR = 2.76；95%CI：1.36 - 5.61，p = 0.005）。对于接受姑息手术的IV期胃癌患者，NLR失去了预测作用（HR = 1.73；95%CI：0.85 - 3.54，p = 0.13）。我们的结果还表明，预后可能受NLR临界值的影响。总之，治疗前NLR升高与胃癌患者的不良结局相关。未来，利用NLR评估患者状况的能力可能用于个性化癌症护理。
