Department of Gastroenterological Surgery, Tsukuba Medical Center Hospital, 1-3-1 Amakubo, Tsukuba, Ibaraki, 305-8558, Japan.
Department of Gastroenterological Surgery, Tsukuba Medical Center Hospital, 1-3-1 Amakubo, Tsukuba, Ibaraki, 305-8558, Japan.
Eur J Surg Oncol. 2018 May;44(5):607-612. doi: 10.1016/j.ejso.2018.02.003. Epub 2018 Feb 13.
The preoperative neutrophil-to-lymphocyte ratio (NLR) is a well-known prognostic marker for gastric cancer patients. However, the utility of the NLR in predicting short-term outcomes in gastric cancer patients remains unclear. Here, we investigated whether the preoperative NLR is a predictor of short-term outcomes in gastric cancer patients.
We retrospectively evaluated 154 consecutive gastric cancer patients. We compared the perioperative outcomes and median survival times (MSTs). In particular, for stage II/III (UICC, 7th edition) gastric cancer patients, we compared median disease-free survival time (MDFST) between the low- and high-NLR groups.
Between the low-NLR group (n = 110) and the high-NLR group (n = 44), significant differences were observed in perioperative outcomes, including postoperative complications (3 (2.7%) vs. 5 (11.3%); p = 0.015), intraoperative blood loss (158 ± 168 g vs. 232 ± 433 g; p = 0.022), and intraoperative blood transfusions (0 vs. 3 (6.8%); p = 0.042). MSTs and MDFSTs were also significantly different (812 vs. 594 days, p = 0.04; and 848 vs. 475 days, p = 0.03, respectively). Multivariate analysis identified the NLR (hazard ratio [HR], 2.015; p = 0.004), Glasgow Prognostic Score (GPS) (HR, 1.533; p = 0.012), and presence of stage III/IV disease (HR, 5.488; p < 0.001), preoperative symptoms (HR, 3.412; p = 0.008), or postoperative complications (HR, 2.698; p < 0.001) as independent prognostic factors.
We suggest that the preoperative NLR is an additional useful predictor of both long-term and short-term outcomes in gastric cancer patients.
术前中性粒细胞与淋巴细胞比值（NLR）是一种广为人知的胃癌患者预后标志物。然而，NLR 预测胃癌患者短期结局的效用尚不清楚。在这里，我们研究了术前 NLR 是否可预测胃癌患者的短期结局。
我们回顾性评估了 154 例连续的胃癌患者。我们比较了围手术期结局和中位生存时间（MST）。特别是对于 II/III 期（UICC，第 7 版）胃癌患者，我们比较了低 NLR 组和高 NLR 组之间的中位无病生存时间（MDFST）。
低 NLR 组（n=110）与高 NLR 组（n=44）之间，围手术期结局存在显著差异，包括术后并发症（3（2.7%）比 5（11.3%）；p=0.015）、术中出血量（158±168g 比 232±433g；p=0.022）和术中输血（0 比 3（6.8%）；p=0.042）。MST 和 MDFST 也存在显著差异（812 比 594 天，p=0.04；848 比 475 天，p=0.03）。多变量分析确定 NLR（风险比[HR]，2.015；p=0.004）、格拉斯哥预后评分（GPS）（HR，1.533；p=0.012）、III/IV 期疾病的存在（HR，5.488；p<0.001）、术前症状（HR，3.412；p=0.008）或术后并发症（HR，2.698；p<0.001）是独立的预后因素。
我们认为术前 NLR 是预测胃癌患者长期和短期结局的另一个有用指标。
