Department of Gastrointestinal Surgery, Yijishan Hospital of Wannan Medical College, Wuhu, Anhui, China.
Fujian Medical University, Fuzhou, Fujian, China.
Jpn J Clin Oncol. 2020 Sep 28;50(10):1141-1149. doi: 10.1093/jjco/hyaa099.
The immune inflammation-based score is recognized as a prognostic marker for cancer. However, the most accurate prognostic marker for patients with gastric cancer remains undetermined. We aimed to evaluate the predictive value of the lymphocyte-to-C-reactive protein ratio for outcomes in gastric cancer patients after radical gastrectomy.
A total of 607 gastric cancer patients treated at three Chinese institutions were included. Receiver operating characteristic curves were generated, and the areas under the curve were calculated to compare the predictive value among the inflammation-based score, lymphocyte-to-C-reactive protein ratio, C-reactive protein/albumin and neutrophil-lymphocyte, platelet-lymphocyte and lymphocyte-monocyte ratios. Cox regression was performed to determine the prognostic factors for overall survival.
The median follow-up time was 63 months (range: 1-84 months). The optimal cut-off value for lymphocyte-to-C-reactive protein ratio was 0.63. The patients were divided into the LCR <0.63 (LLCR, n = 294) group and the LCR ≥0.63 (HLCR, n = 313) group. LLCR was significantly correlated with poor clinical characteristics. Compared with inflammation-based score, lymphocyte-to-C-reactive protein ratio had the highest areas under the curve (0.695). Patients with LLCR experienced more post-operative complications than the HLCR group (20.4 vs. 12.1%, P = 0.006). Multivariate analysis showed that a higher lymphocyte-to-C-reactive protein ratio (HR: 0.545, 95%CI: 0.372-0.799, P = 0.002) was associated with better overall survival. The HLCR group had higher 5-year overall survival rate than the LLCR group (80.5 vs. 54.9%, P < 0.001).
Preoperative lymphocyte-to-C-reactive protein ratio levels can effectively predict the short-term and oncological efficacy of gastric cancer patients after radical gastrectomy with a predictive value significantly better than other inflammation-based score.
免疫炎症评分被认为是癌症的预后标志物。然而，对于胃癌患者，最准确的预后标志物仍未确定。我们旨在评估淋巴细胞与 C 反应蛋白比值对根治性胃切除术后胃癌患者结局的预测价值。
共纳入来自中国 3 家医疗机构的 607 例胃癌患者。生成受试者工作特征曲线，并计算曲线下面积，以比较炎症评分、淋巴细胞与 C 反应蛋白比值、C 反应蛋白/白蛋白、中性粒细胞与淋巴细胞比值、血小板与淋巴细胞比值、淋巴细胞与单核细胞比值的预测价值。采用 Cox 回归确定总生存的预后因素。
中位随访时间为 63 个月（范围：1-84 个月）。淋巴细胞与 C 反应蛋白比值的最佳截断值为 0.63。患者被分为淋巴细胞与 C 反应蛋白比值<0.63（LLCR 组，n=294）和淋巴细胞与 C 反应蛋白比值≥0.63（HLCR 组，n=313）组。LLCR 与较差的临床特征显著相关。与炎症评分相比，淋巴细胞与 C 反应蛋白比值具有更高的曲线下面积（0.695）。与 HLCR 组相比，LLCR 组术后并发症更多（20.4% vs. 12.1%，P=0.006）。多因素分析显示，较高的淋巴细胞与 C 反应蛋白比值（HR：0.545，95%CI：0.372-0.799，P=0.002）与更好的总生存相关。HLCR 组的 5 年总生存率高于 LLCR 组（80.5% vs. 54.9%，P<0.001）。
术前淋巴细胞与 C 反应蛋白比值水平可有效预测根治性胃切除术后胃癌患者的短期和肿瘤疗效，其预测价值明显优于其他炎症评分。
