Department of Gastroenterology, Tokyo Metropolitan Tama Medical Center, Tokyo,
Department of Gastroenterology, Tokyo Metropolitan Tama Medical Center, Tokyo, Japan.
Oncology. 2019;96(3):140-146. doi: 10.1159/000493427. Epub 2018 Oct 26.
The neutrophil-to-lymphocyte ratio (NLR) has been proposed as an indicator of cancer-related inflammation. The aim of our study was to examine the prognostic value of the NLR for patients with advanced gastric cancer receiving second-line chemotherapy.
The association of overall survival (OS) in second-line chemotherapy and the clinicopathological findings including NLR were analyzed retrospectively. The selection criteria were patients who received second-line chemotherapy between January 2010 and June 2015, had histologically confirmed gastric adenocarcinoma, and were followed up until death or for 180 days or longer.
Eighty-six patients met the selection criteria. Multivariate analysis revealed that performance status 2, hemoglobin < 10 g/dL, and NLR before first-line chemotherapy ≥3 were adverse predictive markers. NLR before second-line chemotherapy was not associated with OS. A prognostic model was constructed dividing patients into three groups according to the number of adverse predictive factors: good (no factor), intermediate (one factor), and poor (more than two factors). The median OS for the good, intermediate, and poor groups was 14.3, 7.2, and 4.4 months, respectively (p < 0.001).
Patients with advanced gastric cancer with performance status 2, hemoglobin < 10 g/dL, and NLR before first-line chemotherapy ≥3 are not likely to benefit from second-line chemotherapy.
中性粒细胞与淋巴细胞比值（NLR）已被提出作为癌症相关炎症的指标。我们研究的目的是检查 NLR 对接受二线化疗的晚期胃癌患者的预后价值。
回顾性分析二线化疗的总生存期（OS）与包括 NLR 在内的临床病理发现之间的相关性。入选标准为 2010 年 1 月至 2015 年 6 月期间接受二线化疗、组织学证实为胃腺癌、并随访至死亡或 180 天以上的患者。
86 名患者符合入选标准。多变量分析显示，体能状态 2、血红蛋白<10 g/dL 和一线化疗前 NLR≥3 是不良预测标志物。二线化疗前 NLR 与 OS 无关。根据不良预测因素的数量将患者分为三组：良好（无因素）、中等（一个因素）和差（两个以上因素）。良好、中等和差组的中位 OS 分别为 14.3、7.2 和 4.4 个月（p<0.001）。
体能状态 2、血红蛋白<10 g/dL 和一线化疗前 NLR≥3 的晚期胃癌患者不太可能从二线化疗中获益。
