Division of Reparative Medicine, Institute of Life Sciences, Department of Gastrointestinal and Pediatric Surgery, Mie University Graduate School of Medicine, 2-174 Edobashi, Tsu, Mie, 514-8507, Japan.
Surg Today. 2020 Mar;50(3):223-231. doi: 10.1007/s00595-019-01873-y. Epub 2019 Sep 4.
Gastric cancer (GC) is a common malignancy, especially in East Asian countries. There is emerging evidence that circulating neutrophil and platelet levels correlate with cancer progression. We evaluated the short- and long-term outcomes of GC patients systemically, to compare the original neutrophil-platelet score (NPS) and our modified NPS (mNPS).
We analyzed the original pre-operative NPS and the mNPS of 621 GC patients.
Racial differences between the United Kingdom and East Asian countries accounted for compelling deviation in classification using the original NPS, which could not reliably stratify the prognoses of Japanese GC patients. We developed the mNPS using appropriate cutoff levels for pre-operative neutrophils and platelets, and demonstrated that the pre-operative mNPS was significantly correlated with all of the well-established clinicopathological factors for disease development, including advanced T stage, venous and lymphatic vessel invasion, lymph node/peritoneal /distant metastasis, and tumor-node-metastasis stage. The pre-operative mNPS could stratify prognostication for both overall survival (OS) and disease-free survival (DFS): a high pre-operative mNPS was an independent prognostic factor for the OS and DFS of GC patients and also an independent predictor of post-operative surgical site infection after gastrectomy.
Calculating the mNPS could help clinicians to stratify the surgical and oncological risks of patients with GC.
胃癌（GC）是一种常见的恶性肿瘤，尤其在东亚国家更为常见。有新的证据表明，循环中性粒细胞和血小板水平与癌症进展相关。我们系统性地评估了 GC 患者的短期和长期结局，比较了原始的中性粒细胞-血小板评分（NPS）和我们改良的 NPS（mNPS）。
我们分析了 621 例 GC 患者的原始术前 NPS 和 mNPS。
英国和东亚国家之间的种族差异导致使用原始 NPS 进行分类时出现了令人信服的偏差，无法可靠地区分日本 GC 患者的预后。我们使用适当的术前中性粒细胞和血小板截断值来开发 mNPS，并表明术前 mNPS 与所有已确立的疾病发展的临床病理因素显著相关，包括晚期 T 分期、静脉和淋巴管侵犯、淋巴结/腹膜/远处转移以及肿瘤-淋巴结-转移分期。术前 mNPS 可分层预测总生存期（OS）和无病生存期（DFS）：高术前 mNPS 是 GC 患者 OS 和 DFS 的独立预后因素，也是胃切除术后手术部位感染的独立预测因子。
计算 mNPS 有助于临床医生对 GC 患者的手术和肿瘤风险进行分层。
