Migita Kazuhiro, Matsumoto Sohei, Wakatsuki Kohei, Ito Masahiro, Kunishige Tomohiro, Nakade Hiroshi, Kitano Mutsuko, Nakatani Mitsuhiro, Sho Masayuki
Department of Surgery, Nara Medical University, 840 Shijo-cho, Kashihara, Nara, 634-8522, Japan.
Surg Today. 2018 Mar;48(3):282-291. doi: 10.1007/s00595-017-1582-y. Epub 2017 Aug 23.
The aim of this study was to evaluate the prognostic impact of inflammation-based markers, including the neutrophil-to-lymphocyte ratio (NLR) and prognostic nutritional index (PNI), in patients with recurrent gastric cancer (RGC).
This study reviewed 167 patients with RGC. A receiver operating characteristics (ROC) curve analysis was performed to determine the NLR and PNI cutoff values. The prognostic significance of the NLR and PNI was evaluated by a multivariate analysis.
The optimal NLR and PNI cutoff values for predicting the 1-year survival after recurrence were 2.2 and 47, respectively. A univariate analysis revealed that the NLR (p < 0.001) and PNI (p < 0.001) were significantly associated with the survival time after recurrence, along with the histology, peritoneal recurrence, carbohydrate antigen 19-9, and chemotherapy for recurrence. In the multivariate analysis, a higher NLR (p < 0.001) and a lower PNI (p = 0.002) were independent predictors of a shorter survival time. Among the patients who underwent chemotherapy, the NLR and PNI were also independent prognostic factors.
Inflammation-based markers, including the NLR and PNI, are simple and useful clinical biomarkers that can be used to predict the survival time of patients with RGC.
本研究旨在评估炎症相关指标,包括中性粒细胞与淋巴细胞比值(NLR)和预后营养指数(PNI),对复发性胃癌(RGC)患者预后的影响。
本研究回顾性分析了167例RGC患者。通过绘制受试者工作特征(ROC)曲线分析来确定NLR和PNI的临界值。采用多因素分析评估NLR和PNI的预后意义。
预测复发后1年生存率的最佳NLR和PNI临界值分别为2.2和47。单因素分析显示,NLR(p < 0.001)、PNI(p < 0.001)与复发后的生存时间显著相关,此外还与组织学类型、腹膜复发、糖类抗原19-9以及复发时的化疗情况有关。多因素分析中,较高的NLR(p < 0.001)和较低的PNI(p = 0.002)是生存时间较短的独立预测因素。在接受化疗的患者中,NLR和PNI也是独立的预后因素。
包括NLR和PNI在内的炎症相关指标是简单且有用的临床生物标志物,可用于预测RGC患者的生存时间。