Gu Lihu, Wang Mian, Cui Xuena, Mo Jiahang, Yuan Lingling, Mao Feiyan, Zhang Kang, Ng Derry Minyao, Chen Ping, Wang Dongjie
Department of General Surgery, HwaMei Hospital, University of Chinese Academy of Sciences, Ningbo, Zhejiang, China.
Key Laboratory of Diagnosis and Treatment of Digestive System Tumors of Zhejiang Province, Ningbo, Zhejiang, China.
BMC Surg. 2020 Oct 2;20(1):219. doi: 10.1186/s12893-020-00884-8.
The prognostic significance of peripheral blood-derived inflammation markers in patients with gastric cancer (GC) has not been elucidated. This study aimed to investigate the relationship between systemic inflammatory markers and GC prognosis.
A prospective observational cohort study involving 598 patients was conducted to analyze the prognosis of GC based on systemic inflammatory markers. The following peripheral blood-derived inflammation markers were evaluated: the neutrophil-lymphocyte ratio (NLR), platelet lymphocyte ratio (PLR), systemic immune-inflammation index (SII), C-reactive protein/albumin (CRP/Alb) ratio, Glasgow Prognostic Score (GPS), modified Glasgow Prognostic Score (mGPS), prognostic nutrition index (PNI), and prognostic index (PI). The receiver operating characteristics (ROC) curve and the Youden index were used to determine the optimal cutoff values. Univariate and multivariate analysis of prognostic factors was conducted accordingly.
The optimal cutoff values of the PNI, fibrinogen, NLR, PLR, SII, and CRP/Alb were 49.5, 397 ng/dl, 2.5, 154, 556, and 0.05, respectively. Multivariate analysis showed that age, PLR, TNM stage, and chemotherapy were the independent prognostic factors for advanced gastric cancer (AGC). Adjuvant chemotherapy improved the long-term prognosis of patients with PLR ≥154, but chemotherapy had no significant effect on the survival of patients with PLR < 154.
Our findings show that higher PLR (≥154) is an independent risk factor for poor prognosis in GC patients. Besides, PLR can predict adjuvant chemotherapy (oxaliplatin/5-fluorouracil combination) response in patients with GC after surgery.
外周血源性炎症标志物在胃癌（GC）患者中的预后意义尚未阐明。本研究旨在探讨全身炎症标志物与GC预后之间的关系。
进行了一项涉及598例患者的前瞻性观察队列研究，以基于全身炎症标志物分析GC的预后。评估了以下外周血源性炎症标志物：中性粒细胞与淋巴细胞比值（NLR）、血小板与淋巴细胞比值（PLR）、全身免疫炎症指数（SII）、C反应蛋白/白蛋白（CRP/Alb）比值、格拉斯哥预后评分（GPS）、改良格拉斯哥预后评分（mGPS）、预后营养指数（PNI）和预后指数（PI）。采用受试者工作特征（ROC）曲线和尤登指数确定最佳临界值。相应地进行了预后因素的单因素和多因素分析。
PNI、纤维蛋白原、NLR、PLR、SII和CRP/Alb的最佳临界值分别为49.5、397 ng/dl、2.5、154、556和0.05。多因素分析显示，年龄、PLR、TNM分期和化疗是晚期胃癌（AGC）的独立预后因素。辅助化疗改善了PLR≥154患者的长期预后，但化疗对PLR<154患者的生存无显著影响。
我们的研究结果表明，较高的PLR（≥154）是GC患者预后不良的独立危险因素。此外，PLR可以预测GC术后患者对辅助化疗（奥沙利铂/5-氟尿嘧啶联合）的反应。
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