Li Qiong, Huang Lin-Yi, Xue Hui-Ping
Department ofGastroenterology and Hepatology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200001, China.
World J Gastrointest Oncol. 2020 Oct 15;12(10):1146-1166. doi: 10.4251/wjgo.v12.i10.1146.
Gastric cancer (GC) is one of the most common malignant tumors in the world. Although in recent years tremendous progress has been made in its early detection, the postoperative overall survival (OS) of GC patients remains extremely low. A number of studies have shown that age, to varying degrees, affects the prognosis of patients with GC. Therefore, this study retrospectively analyzed the clinical and pathologic data of patients with GC to explore the differences in the clinical characteristics and prognostic factors in different age groups.
To explore the difference in clinicopathological characteristics and prognostic factors in GC patients in different age groups.
In this retrospective study, we analyzed 1037 GC patients admitted to Renji Hospital Affiliated to Shanghai Jiao Tong University School of Medicine from May 2010 to January 2013. The patients were divided into two groups based on age: Younger group (less than 70 years old) and older group (no less than 70 years old). In the younger group, we subdivided the patients in two subgroups by a cut-off value of 45 years. The clinical features and prognostic factors were analyzed in both groups. Subsequently, we retrieved studies that evaluated the predictive role of neutrophil-lymphocyte ratio (NLR) by searching two medical databases, PubMed and EMBASE, to conduct a meta-analysis. Random-effects model was used to pool the data.
In the retrospective study, the mean OS time of the younger group (64.7 mo) was significantly longer than that of the older group (48.1 mo) ( < 0.001). Among patients under 70 years of age, hospitalization time, tumor-node-metastasis (TNM) stage, vascular invasion, and preoperative low pre-albumin were independently associated with OS ( < 0.005). In patients aged 70 years and above, TNM stage, esophageal invasion, histological type, and preoperative NLR were independent factors for OS ( < 0.05). The OS of these older patients was also significantly shorter ( < 0.05). In the meta-analysis, 19 retrieved studies included a total of 8312 patients, among whom 3558 had elevated NLR values. The results showed that high NLR value was a risk factor for the prognosis of GC ( < 0.01).
The OS of elderly patients is significantly worse than that of younger patients. There are significant differences in clinicopathological characteristics and prognostic factors between younger and older patients. NLR is a convenient, inexpensive, and reproducible marker that can be used as an important predictor of the prognosis of GC.
胃癌（GC）是世界上最常见的恶性肿瘤之一。尽管近年来其早期检测取得了巨大进展，但GC患者术后的总生存期（OS）仍然极低。多项研究表明，年龄在不同程度上影响GC患者的预后。因此，本研究回顾性分析了GC患者的临床和病理数据，以探讨不同年龄组患者的临床特征和预后因素的差异。
探讨不同年龄组GC患者的临床病理特征和预后因素的差异。
在这项回顾性研究中，我们分析了2010年5月至2013年1月期间上海交通大学医学院附属仁济医院收治的1037例GC患者。根据年龄将患者分为两组：较年轻组（小于70岁）和较年长组（不小于70岁）。在较年轻组中，我们以45岁为分界值将患者再细分为两个亚组。分析了两组的临床特征和预后因素。随后，我们通过检索两个医学数据库PubMed和EMBASE，检索评估中性粒细胞与淋巴细胞比值（NLR）预测作用的研究，以进行荟萃分析。采用随机效应模型汇总数据。
在回顾性研究中，较年轻组的平均OS时间（64.7个月）显著长于较年长组（48.1个月）（<0.001）。在70岁以下的患者中，住院时间、肿瘤-淋巴结-转移（TNM）分期、血管侵犯和术前低前白蛋白与OS独立相关（<0.005）。在70岁及以上的患者中，TNM分期、食管侵犯、组织学类型和术前NLR是OS的独立因素（<0.05）。这些较年长患者的OS也显著较短（<0.05）。在荟萃分析中，检索到的19项研究共纳入8312例患者，其中3558例NLR值升高。结果显示，高NLR值是GC预后的危险因素（<0.01）。
老年患者的OS明显差于年轻患者。年轻和老年患者在临床病理特征和预后因素方面存在显著差异。NLR是一种方便、廉价且可重复的标志物，可作为GC预后的重要预测指标。
