1 Department of Gastrointestinal Surgery, Harbin Medical University Cancer Hospital, Harbin Medical University, Harbin, Heilongjiang, China.
2 Department of Breast Surgical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Technol Cancer Res Treat. 2019 Jan 1;18:1533033819829485. doi: 10.1177/1533033819829485.
Inflammation plays an important role in tumor progression. Predicting survival is remarkably difficult in patients with gastric cancer receiving neoadjuvant chemotherapy. The aim of the present study is to investigate the potential prognostic significance of the platelet-to-lymphocyte ratio in patients with gastric cancer receiving S-1 plus oxaliplatin or oxaliplatin and capecitabine regimen.
Ninety-one patients with gastric cancer treated with neoadjuvant chemotherapy were enrolled in this study and then underwent operation. The optimal cutoff value was calculated using receiver-operating characteristic curve analyses. The optimal cutoff value of platelet-to-lymphocyte ratio was divided into low platelet-to-lymphocyte ratio <162 group and high platelet-to-lymphocyte ratio ≥162 group. Kaplan-Meier method and log-rank test were used to analyze the survival curves. The independent prognostic factors and prognostic value of the platelet-to-lymphocyte ratio were assessed by univariate and multivariate Cox proportional hazards regression model. The toxicity was evaluated according to the National Cancer Institute Common Toxicity Criteria.
Kaplan-Meier analyses revealed that patients with low platelet-to-lymphocyte ratio correlated remarkably with better mean disease-free survival and mean overall survival than those with high platelet-to-lymphocyte ratio (mean disease-free survival 47.33 and 33.62 months, respectively; mean overall survival 51.21 and 36.80 months, respectively). The results demonstrated that platelet-to-lymphocyte ratio had prognostic significance using the cutoff value of 162 on disease-free survival and overall survival, and the mean disease-free survival and overall survival time for patients with low platelet-to-lymphocyte ratio were longer than those with high platelet-to-lymphocyte ratio. Meanwhile, patients with gastric cancer who had lower platelet-to-lymphocyte ratio had longer 1-, 3-, and 5-year rates of disease-free survival and overall survival. Moreover, patients with low platelet-to-lymphocyte ratio had longer mean disease-free survival and overall survival than those with high platelet-to-lymphocyte ratio in receiving S-1 plus oxaliplatin or oxaliplatin and capecitabine regimen.
The preoperative platelet-to-lymphocyte ratio may be a promising and convenient prognostic biomarker for patients gastric cancer receiving S-1 plus oxaliplatin or oxaliplatin and capecitabine regimen neoadjuvant chemotherapy. It may be useful to help the doctors identify the high-risk patients for taking efficient treatment strategy decisions.
炎症在肿瘤进展中起着重要作用。接受新辅助化疗的胃癌患者的生存预测非常困难。本研究旨在探讨血小板与淋巴细胞比值对接受 S-1 联合奥沙利铂或奥沙利铂联合卡培他滨方案新辅助化疗的胃癌患者的潜在预后意义。
本研究纳入了 91 例接受新辅助化疗的胃癌患者，并进行了手术。使用受试者工作特征曲线分析计算最佳截断值。将血小板与淋巴细胞比值的最佳截断值分为低血小板与淋巴细胞比值<162 组和高血小板与淋巴细胞比值≥162 组。使用 Kaplan-Meier 法和对数秩检验分析生存曲线。通过单因素和多因素 Cox 比例风险回归模型评估血小板与淋巴细胞比值的独立预后因素和预后价值。根据国家癌症研究所常见毒性标准评估毒性。
Kaplan-Meier 分析显示，低血小板与淋巴细胞比值组患者的平均无病生存期和总生存期均显著长于高血小板与淋巴细胞比值组（平均无病生存期分别为 47.33 和 33.62 个月，平均总生存期分别为 51.21 和 36.80 个月）。结果表明，血小板与淋巴细胞比值在无病生存和总生存方面的截断值为 162 时具有预后意义，低血小板与淋巴细胞比值组患者的平均无病生存和总生存时间长于高血小板与淋巴细胞比值组。同时，血小板与淋巴细胞比值较低的胃癌患者的 1 年、3 年和 5 年无病生存率和总生存率均较长。此外，在接受 S-1 联合奥沙利铂或奥沙利铂联合卡培他滨方案新辅助化疗的患者中，低血小板与淋巴细胞比值组的平均无病生存和总生存时间长于高血小板与淋巴细胞比值组。
术前血小板与淋巴细胞比值可能是接受 S-1 联合奥沙利铂或奥沙利铂联合卡培他滨方案新辅助化疗的胃癌患者有前途和方便的预后生物标志物。它可能有助于医生识别高危患者，以便采取有效的治疗策略决策。
