Ye Huaping, Kang Rong, Chen Mao, Zhang Si, Yang Jinfeng
Department of Gastrointestinal Surgery, The First Affiliated Hospital of Chengdu Medical College, Chengdu, People's Republic of China.
Department of Urology, The First Affiliated Hospital of Chengdu Medical College, Chengdu, People's Republic of China.
Ther Clin Risk Manag. 2025 Jul 19;21:1107-1119. doi: 10.2147/TCRM.S532863. eCollection 2025.
This study aimed to evaluate the prognostic significance of the preoperative neutrophil-to-albumin ratio (NAR) in patients with advanced gastric cancer undergoing radical gastrectomy.
A retrospective analysis was conducted involving 526 patients diagnosed with locally advanced gastric adenocarcinoma who underwent radical gastrectomy between January 2017 and December 2019. Preoperative NAR values were calculated using neutrophil count and serum albumin levels obtained within 24 hours of admission. Patients were stratified into high-NAR and low-NAR groups using an optimal cut-off value determined by receiver operating characteristic analysis. Kaplan-Meier curves, univariate, and multivariate Cox regression analyses were used to evaluate overall survival and recurrence-free survival.
The optimal NAR cut-off value was identified as 2.8. Patients with high NAR exhibited significantly worse overall survival and recurrence-free survival compared to the low-NAR group. High NAR was significantly associated with advanced tumor stage, incomplete resection status, administration of chemotherapy and radiotherapy, and poor histological differentiation (all P < 0.0001). Multivariate analyses confirmed NAR as an independent prognostic factor for both overall survival (HR=2.67; 95% CI, 1.97-4.25; p = 0.002) and recurrence-free survival (HR=3.51; 95% CI, 1.58-5.26; p = 0.003).
The preoperative neutrophil-to-albumin ratio is an independent and reliable prognostic biomarker for overall and recurrence-free survival in patients with advanced gastric cancer undergoing radical gastrectomy. Due to its accessibility, simplicity, and predictive value, the neutrophil-to-albumin ratio can effectively facilitate risk stratification, personalized clinical decision-making, and targeted interventions to improve patient outcomes.
本研究旨在评估术前中性粒细胞与白蛋白比值（NAR）对接受根治性胃切除术的进展期胃癌患者的预后意义。
对2017年1月至2019年12月期间526例诊断为局部进展期胃腺癌并接受根治性胃切除术的患者进行回顾性分析。术前NAR值通过入院后24小时内获得的中性粒细胞计数和血清白蛋白水平计算得出。采用受试者工作特征分析确定的最佳临界值，将患者分为高NAR组和低NAR组。采用Kaplan-Meier曲线、单因素和多因素Cox回归分析评估总生存期和无复发生存期。
确定最佳NAR临界值为2.8。与低NAR组相比，高NAR患者的总生存期和无复发生存期显著更差。高NAR与肿瘤晚期、切除不完整状态、化疗和放疗的实施以及组织学分化差显著相关（均P<0.0001）。多因素分析证实NAR是总生存期（HR=2.67；95%CI，1.97-4.25；p=0.002）和无复发生存期（HR=3.51；95%CI，1.58-5.26；p=0.003）的独立预后因素。
术前中性粒细胞与白蛋白比值是接受根治性胃切除术的进展期胃癌患者总生存期和无复发生存期的独立且可靠的预后生物标志物。由于其可及性、简单性和预测价值，中性粒细胞与白蛋白比值可有效促进风险分层、个性化临床决策制定和针对性干预，以改善患者预后。
