| Objective: Gastric cancer is one of the most common malignant tumors in the world,the forth incidence of malignant tumors in men.Nearly 1 million patients suffered gastric cancer each year.About 70% of the gastric cancer new and death patients are in developing countries,including China.At present,surgical resection is still the most important treatment for gastric cancer,but some patients also have high change to suffer local recurrence and distant metastasis after primary tumor resection.The U.S.epidemiological survey showed that 5-year overall survival rate(OS)of patients with gastric cancer was about 26%,while the OS of the early-detective patients could be increased to 63%.East Asian countries,such as Japan,have a higher 5-year survival rate(50%)reported which mainly due to early detection and treatment.In recent years,with the deepening of research on the occurrence and development of tumor,plenty of evidences showed that systemic inflammatory reaction was related to tumor progression,invasion and metastasis.On the one hand,the mechanism showed the direct infiltration of tumor or the infiltration of lymphocytes in tumor microenvironment can promote the body to produce a series of inflammatory transmitters,cytokines.On the other hand,inflammatory transmitters such as IL-6,TNF,neutrophils and inflammatory cells can play a role in the occurrence,invasion and metastasis of tumors by promoting angiogenesis and tissue infiltration.This inflammatory reaction can be reacted by some inflammatory cells and inflammatory proteins in the serum,such as platelets,neutrophils,lymphocytes,C-reactive protein,albumin,etc.Although the specific mechanism of systemic inflammatory response associated with tumor prognosis remains unclear,many studies have shown that inflammatory markers based on these inflammatory cells and inflammatory proteins are associated with the prognosis of patients with gastric cancer.Methods: The clinical and pathological data were all derived from the surgery of gastrointestinal tumor surgery in the First Hospital of China Medical University from2005 to 2010,and all patients underwent radical gastrectomy.Each of cases included a cancer tissue and a non-cancer tissue of at least 5cm away from the cancer foci.None of the patients received any form of radiotherapy or chemotherapy before surgery.Patient cohort:: We retrospectively analyzed the gastric cancer patients who underwent surgical treatment of gastrointestinal tumor surgery in the First Hospital affiliated of China Medical University.Patients without the records of preoperative blood index levels,metastatic disease and those who received neoadjuvant therapy were excluded.Eventually,870 patients were included in the study(follow-up up to March 2015).Clinical records,including age,sex,pathological features and preoperative laboratory examinations,were obtained from the patient’s electronic medical records.The subjects collected fasting venous blood 1-14 days before operation.Prognostic Nutrition Index(PNI)= blood plasma(g/l)+5x absolute value of total lymphocyte count(109/L).We staged cases reference to AJCC/UICC Eighth edition TNM staging.Statistical analysis: We used SPSS22.0 statistical software analysis.And Survival analysis was carried out by the Kaplan-meier method,Log-rank test was performed,and Cox proportional risk regression model was used for multifactor analysis in survival.All the test hypotheses of statistical analysis were statistically significant in P<0.05.Results: 1.Inflammation related markers levels were significantly correlated with age, tumor differentiation,tumor location,p T category,and TNM stage(P < 0.05)but were not significantly associated with sex(P = 0.299)and p N category(P = 0.359).2.In the multivariate analysis,Inflammation related markers was not independently correlated with worse OS.Conclusion: Inflammation related markers was associated with GC clinicalpathology and prognosis. |
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