Tanioka Hiroaki, Okawaki Makoto, Yano Shuya, Yoshimitsu Tomomi, Tokuda Kikue, Nyuya Akihiro, Yamaguchi Yoshiyuki, Nagasaka Takeshi
Department of Clinical Oncology, Kawasaki Medical School, Kurashiki, Okayama 701-0192, Japan.
Oncol Lett. 2023 Jan 27;25(3):98. doi: 10.3892/ol.2023.13684. eCollection 2023 Mar.
The neutrophil-to-lymphocyte ratio (NLR) is a well-known prognostic biomarker for patients with gastric cancer (GC). However, for patients with GC treated with palliative chemotherapy, the predictive values of NLR remain obscure. Therefore, the present study evaluated the clinical impact of NLR in patients with GC treated with a series of chemotherapies. The present study retrospectively evaluated 83 patients with unresectable GC who received a series of chemotherapies. NLR in the blood was calculated before each chemotherapy initiation (before 1st-, 2nd- and 3rd-line treatment). Of the 83 patients enrolled, 56 patients (67%) received 2nd-line chemotherapy and 34 patients (41%) received 3rd-line chemotherapy. NLR at 1st-line ranged from 0.72 to 48.9 (median NLR, 3.00). Therefore, the median NLR of 3.00 was used as a definite cut-off value throughout the present study. All patients were dichotomized into NLR-high (>3.00) and NLR-low group (<3.00) by NLR evaluated before each line of chemotherapy. The median overall survival (OS) time of the low-NLR group was better than that of the high-NLR group from 1st-line to 3rd-line treatment (1st-line: 18.1 vs. 8.0 months, P=0.06; 2nd-line: 10.7 vs. 4.5 months, P=0.0001; 3rd-line: 8.7 vs. 4.7 months, P=0.003). Of the 24 patients treated with 3rd-line nivolumab, patients with low NLR exhibited better OS than those with high NLR (8.3 months in low-NLR and 6.6 months in high-NLR, P=0.06). In conclusion, NLR should be performed before each chemotherapy line in the clinical setting and may predict outcomes in patients with unresectable GC, including those treated with nivolumab.
中性粒细胞与淋巴细胞比值（NLR）是胃癌（GC）患者众所周知的预后生物标志物。然而，对于接受姑息化疗的GC患者，NLR的预测价值仍不明确。因此，本研究评估了NLR对接受一系列化疗的GC患者的临床影响。本研究回顾性评估了83例接受一系列化疗的不可切除GC患者。在每次化疗开始前（第1、2和3线治疗前）计算血液中的NLR。在纳入的83例患者中，56例（67%）接受了二线化疗，34例（41%）接受了三线化疗。一线治疗时NLR范围为0.72至48.9（NLR中位数为3.00）。因此，在本研究中，3.00的NLR中位数被用作明确的临界值。根据各线化疗前评估的NLR，将所有患者分为NLR高（>3.00）组和NLR低（<3.00）组。从一线到三线治疗，低NLR组的中位总生存期（OS）时间优于高NLR组（一线：18.1个月对8.0个月，P=0.06；二线：10.7个月对4.5个月，P=0.0001；三线：8.7个月对4.7个月，P=0.003）。在24例接受三线纳武单抗治疗的患者中，NLR低的患者OS优于NLR高的患者（NLR低的患者为8.3个月，NLR高的患者为6.6个月，P=0.06）。总之，在临床环境中，应在每条化疗线之前检测NLR，其可能预测不可切除GC患者的预后，包括接受纳武单抗治疗的患者。
