Lou Neng, Zhang Liang, Chen Xiao-Dong, Pang Wen-Yang, Arvine Chandoo, Huang Yin-Peng, Zhuang Cheng-Le, Shen Xian
Department of Gastrointestinal Surgery, The First Affiliated Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China.
Department of General Surgery, The Affiliated Taizhou Municipal Hospital, Taizhou University, Taizhou, Zhejiang, China.
J Surg Res. 2017 Mar;209:153-161. doi: 10.1016/j.jss.2016.10.011. Epub 2016 Oct 15.
Precise determination of the lymph node status is critical for determining appropriate treatment for early gastric cancer (EGC). This study attempted to establish a simple, effective risk scoring system to predict lymph node metastasis (LNM) in EGC by investigating the relationship between platelet-to-lymphocyte ratio (PLR) and neutrophil-to-lymphocyte ratio (NLR) and EGC LNM.
We retrospectively reviewed 312 operable patients with EGC. The clinical utility of PLR and NLR was tested by receiver operating characteristic curves. The scoring system was developed using independent risk factors. Finally, 89 EGC patients were collected from prospective database to validate the scoring system's accuracy.
The optimal PLR and NLR cut-off values were 106 and 2.97, respectively. High NLR (P = 0.009) and PLR (P = 0.007) values were associated with LNM of EGC in univariate analyses, although only high PLR (P = 0.025) was an independent risk factor in multivariate analyses, together with age (P = 0.009), differentiation (P = 0.017), invasive depth (P < 0.001), and tumor size (P = 0.003). The scoring system's accuracy for retrospective and prospective data was 0.781 (95% confidence interval: 0.721-0.841) and 0.817 (95% confidence interval 0.714-0.920), respectively.
Preoperative PLR and NLR correlate with EGC LNM. Our scoring system is reliable, accurate, and effective in predicting LNM in EGC patients.
准确确定淋巴结状态对于早期胃癌（EGC）的恰当治疗至关重要。本研究试图通过调查血小板与淋巴细胞比值（PLR）和中性粒细胞与淋巴细胞比值（NLR）与EGC淋巴结转移（LNM）之间的关系，建立一种简单、有效的风险评分系统来预测EGC中的LNM。
我们回顾性分析了312例可手术的EGC患者。通过受试者工作特征曲线测试PLR和NLR的临床效用。使用独立危险因素建立评分系统。最后，从前瞻性数据库中收集了89例EGC患者以验证评分系统的准确性。
最佳PLR和NLR临界值分别为106和2.97。单因素分析中，高NLR（P = 0.009）和PLR（P = 0.007）值与EGC的LNM相关，尽管多因素分析中只有高PLR（P = 0.025）是独立危险因素，此外还有年龄（P = 0.009）、分化程度（P = 0.017）、浸润深度（P < 0.001）和肿瘤大小（P = 0.003）。评分系统对回顾性和前瞻性数据的准确性分别为0.781（95%置信区间：0.721 - 0.841）和0.817（95%置信区间0.714 - 0.920）。
术前PLR和NLR与EGC的LNM相关。我们的评分系统在预测EGC患者的LNM方面可靠、准确且有效。
