Clinical And Pathological Characteristics Of NLR And PLR In Peripheral Blood And Gastric Adenocarcinoma Prognostic Correlation Analysis

Objective:The purpose of this study was to analyze the correlation between preoperative peripheral blood neutrophil to lymphocyte ratio(NLR)and platelet to lymphocyte ratio(PLR)with clinicopathological characteristics and postoperative survival rate in patients with gastric cancer undergoing surgical treatment and to evaluate the predictive value of preoperative NLR.PLR in patients with gastric cancer.Methods:The data of patients with gastric cancer who underwent surgical treatment in Qilu Hospital of Shandong University from January 2014 to December 2015 were analyzed retrospectively.The baseline characteristics of the patients,the results of preoperative blood routine test,TNM stage,tumor differentiation and histologic classification were documented.The gastric cancer patients enrolled were followed up for 3 years by telephone or outpatient follow-up to determine the survival status.The optimal critical values of preoperative NLR and PLR for predicting the survival rate of patients with gastric cancer were determined by establishing the working characteristic curve(ROC curve)of the subjects.The patients were divided into high NLR group,low NLR group,high PLR gro up and low PLR group according to the optimal critical value.The clinicopathological data and 3-year survival rate of different groups were analyzed and compared.Cox multivariate analysis was used to explore the independent risk factors affecting the 3-year survival rate of p atients with gastric cancer.and to evaluate the predictive value of preoperative NLR and PLR for survival rate.Results:A total of 587 patients with gastric adenocarcinoma undergoing surgery from January 1,2014 to December 3 1.2015 were enrolled in this study of which 528 patients received complete follow-up data.The median age of 528 patients was 64(29-82)years old.and there were 359 male patients(68.0%)with gastric cancer.We determined the optimal cutoff value of NLR by ROC curve was 2.9.the sensitivity was 0.74.and the specificity was 0.56.The area under the ROC curve is 0.633(95%CI 0.611-0.655,P<0.001):The cutoff value of PLR was 164,the sensitivity was 0.72,the specificity was 0.51,and the area under the ROC curve was 0.607(95%CI 0.585-0.629.P<0.001)According to the optimal critical value of NLR,the patients were divided into high NLR group(>2.9)and low NLR group(<2.9).Compared with the patients in the low NLR group,the patients in the high NLR group were older and had larger tumor diameters,higher levels of CEA and CA-199,and the ratio of patients with low differentiation and TNM stage Ⅲ-Ⅳ was higher(P<0.05).According to the optimal critical value of PLR.the patients were divided into high PLR group(>164)and low PLR group(<164)Compared with the low-PLR group,the CEA level was higher in the high-PLR group,with a higher proportion of patients in T3-4.N2-3.and TNM Ⅲ-Ⅳ(P<0.05).Survival analysis showed that the survival rate of gastric cancer patients in low NLR group was 51.8%.and that in high NLR group was 39.2%.The survival rate in high NLR group was significantly lower than that in low NLR group(P=0.001).The surival rate of patients with gastric cancer in low PLR group and high PLR group was 50.3%and 39.8%.The survival rate in high PLR group was significantly lower than that in low PLR group(P=0.02).COX multivariate regression analysis showed that low-differentiated tumors(HR=1.96;95%CI:1.28-3.00:P=0.002),TNM stage Ⅲ-Ⅳ(HR=1.25;95%CI:1.09-1.43:P=0.001),NLR>2.9(HR=1.13;95%CI:1.04-1.23;P=0.003)are independent risk factors that affect the 3-year survival rate of gastric cancer patients.Conclusion:NLR and PLR are significantly correlated with CEA level,pathological differentiation and TNM stage in gastric cancer patients2.Preoperative gastric cancer patients with high NLR levels have lower survival rates than patients with low NLR levels,and preoperative patients with high PLR levels have lower survival rates than patients with lower PLR levels.3.Preoperative high NLR level is an independent risk factor affecting the survival rate of gastric cancer patients...