Nonogaki Akira, Kanda Mitsuro, Ito Seiji, Mochizuki Yoshinari, Teramoto Hitoshi, Ishigure Kiyoshi, Murai Toshifumi, Asada Takahiro, Ishiyama Akiharu, Matsushita Hidenobu, Tanaka Chie, Kobayashi Daisuke, Fujiwara Michitaka, Murotani Kenta, Kodera Yasuhiro
Department of Gastroenterological Surgery (Surgery II), Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550, Japan.
Department of Gastroenterological Surgery, Aichi Cancer Center Chuo Hospital, Nagoya, Japan.
Surg Today. 2023 Feb;53(2):198-206. doi: 10.1007/s00595-022-02539-y. Epub 2022 Jun 29.
Peritoneal dissemination is the key to the prognosis of gastric cancer (GC) and can be detected early with peritoneal lavage cytology. No studies have examined preoperative prognostic factors in GC patients who have positive cytology but no other non-curative factors.
We conducted a retrospective analysis using a multicenter database of 3575 patients who underwent gastrectomy between 2010 and 2014. Patients with positive peritoneal lavage cytology as a sole non-curative factor were retrieved, and correlations between parameters and the prognosis were compared.
A total of 66 patients were identified as eligible. In the receiver operating characteristic (ROC) curve analysis, the neutrophil-to-platelet ratio (NPR) had the greatest area under the curve value and was selected. We divided the NPR into two groups based on the optimal cutoff value of the NPR (2.000), as determined by the ROC curve analysis. A high preoperative NPR was the only prognostic factor. The NPR-high group had shorter overall survival than the NPR-low group (hazard ratio 1.85, 95% confidence interval 1.05-3.28, P = 0.032).
Our analysis indicated that the preoperative NPR serves as a prognostic factor in GC patients with positive peritoneal lavage cytology in the absence of other non-curative factors.
腹膜播散是胃癌（GC）预后的关键因素，可通过腹腔灌洗细胞学检查早期发现。目前尚无研究探讨细胞学检查阳性但无其他非治愈性因素的GC患者的术前预后因素。
我们使用一个多中心数据库对2010年至2014年间接受胃切除术的3575例患者进行了回顾性分析。检索以腹腔灌洗细胞学检查阳性作为唯一非治愈性因素的患者，并比较各项参数与预后之间的相关性。
共确定66例符合条件的患者。在受试者工作特征（ROC）曲线分析中，中性粒细胞与血小板比值（NPR）的曲线下面积值最大，因此被选用。根据ROC曲线分析确定的NPR最佳临界值（2.000）将NPR分为两组。术前高NPR是唯一的预后因素。NPR高分组的总生存期短于NPR低分组（风险比1.85，95%置信区间1.05 - 3.28，P = 0.032）。
我们的分析表明，术前NPR可作为无其他非治愈性因素、腹腔灌洗细胞学检查阳性的GC患者的预后因素。
