Significance Of Preoperative PLR And NLR In Classification Of Risk Of Gastrointestinal Stromal Tumor

Objective To investigate the relationship between the ratio of neutrophil to lymphocyte(NLR)and the ratio of platelet to lymphocyte(PLR)in the classification of risk of gastrointestinal stromal tumors.Methods A total of 103 patients with gastrointestinal stromal tumors hospitalized in Yanbian University Affiliated Hospital from January 2010 to December 2017 were collected,and 50 healthy adults during the same period.Record basic information such as patient's age,gender,nationality,and clinical,pathological,laboratory and other detailed information.Calculate NLR and PLR values for all cases.NLR values were derived from neutrophils divided by lymphocytes.PLRs were derived from platelets divided by lymphocytes.According to the risk grading standards agreed by the United States Department of Health(NIH)in 2008 on the GIST,all GISTs were divided into 34 low-risk groups,21 medium-risk groups,and 48 high-risk groups(Because the number of patients with very low risk is small,they are classified as low risk group).The control group was 50 healthy checkers.The difference between NLR and PLR and different risk grades was compared between groups to predict prognosis.Results 1.Compared with control group,NLR and the PLR malignant GIST medium and high group increased significantly(P<0.01);No significant difference in low malignant GIST group(P>0.05).2.PLR and NLR were statistically significant among the three groups.The NLR and PLR in the moderate and high degree of malignancy were significantly higher than those in the low risk group(P<0.01).3.The AUC of the ROC curve for the NLR values was in the order of height group>medium group>low group,and the corresponding area under the curve was 0.581,0.780,and 0.787.The AUC of the ROC curve for the PLR values was in the order of height group>medium group>low group,and the corresponding area under the curve was 0.609,0.750,and 0.830(low group P>0.05,moderate and high group P<0.05).4.The cut-off value of ROC curve of low,moderate and high groups of NLR were 3.07,2.73 and 2.08,sensitivity were 26.5%,61.9%,76.6%and specificity were 92%and 84%,70%;(low group P>0.05,moderate and high group P<0.05).The cut-off values of ROC curves of low,medium and high groups of PLR were 157.41,143.51,155.23,and the sensitivity were 32.4%,57.1%,63.8%,and the specificity was 96%,88%,96%(low group P>0.05,moderate and high group P<0.05).Conclusion At very low and low risk,PLR and NLR have low diagnostic value for GIST;when moderate risk and high risk,PLR and NLR have high value for diagnosis of GIST,especially high risk.Preoperative high NLR and PLR can be used as predictors of tumor risk in GIST.