Analysis Of Distribution Factors Of Preoperative Neutrophil Lymphocyte Ratio In Patients With Gastric Cancer

Objective:To explore the relationship between distribution of neutrophil lymphocyte ratio(NLR)and tumor pathology in patients with gastric cancer.Methods:A total of 706 patients with gastric cancer who underwent radical gastrectomy were selected from the First Affiliated Hospital of Anhui Medical University from August 2016 to December 2017.The results of the first blood routine test were collected,including neutrophil count and lymphocyte count.The patient’s sex,age,BMI,T stage(invasion depth),N stage,M stage,pTNM,tissue differential type,tissue differential degree,tumor location,number of detected lymph nodes,number of metastatic lymph nodes,maximum diameter of tumor and carcinoembryonic antigen(CEA)were recorded.Univariate analysis and multivariate analysis were used to analyze the influencing factors of NLR distribution in gastric cancer patients.Results: 400 were in the low NLR group and 306 in the high NLR group of the 706 patients.Analysis reveals that the average value of NLR in each T stage,N stage and pTNM stage showed a gradual upward trend.Patients with high NLR are more likely to transfer lymph nodes.The difference was not statistically significant(P<0.05)in sex,age,tissue differential type,tissue differential degree,M-stage,tumor location and CEA compared with NLR.BMI,T stage,N stage,pTNM and maximum diameter of tumor were significantly different from NLR(P<0.05).Multivariate logistic regression analysis showed that the maximum diameter of tumor was an independent risk factor affecting NLR(P<0.020).And the gastric cancer patients with a tumor diameter of at least 2.5 cm risks 1.790 times more high-NLR than the tumor with a maximum diameter of less than 2.5 cm(95% CI: 1.994~ 2.928).When the ROC analysis of NLR based on logistic regression model for predicting NLR value and maximum diameter of tumors.The AUC values were 0.633 and 0.604,respectively,P < 0.001,indicating that the distribution of NLR in different gastric cancer patients was different.Conclusion:Preoperative NLR has a suggestive effect on the depth of tumor invasion and lymph node involvement.It is also affected by BMI.Distribution level of NLR in different patients was significantly different.The maximum diameter of tumor can be used as an independent risk of affecting NLR in the multivariate analysis.