Associations Of Preoperative Blood NLR And PLR With The Prognosis Of Gastroin-testinal Stromal Tumor And Its Clinical Significance

Objective:To explore the associations of preoperative blood neutrophil to lymphocyte ratio(NLR)and platelet to lymphocyte ratio(PLR)with the prognosis of gastrointestinal stromal tumors(GIST)and its clinical significance.Methods:One hundred and fifty-one patients who underwent operative resection for primary localized GIST with preoperative results for neutrophil,platelet,and lymphocyte counts available were retrospectively reviewed.The patients were divided high NLR(?3.0)/PLR(?146.7)and low NLR(?3.0)/PLR(?146.7)groups according to the optimal cut off values of the receiver operating characteristic(ROC)curves.Prognostic factors of RFS were determined using univariate and multivariate Cox regression analyses for the 151 patients who did not receive adjuvant imatinib.Results:The patients with high NLR and PLR short RFS than those with low NLR and PLR.On univariate analyses,location,tumor size,mitotic count,necrosis,and both a high NLR and PLR were significant prognostic indicators of decreased RFS(hazard ratio [HR]: 4.165 [95% CI:1.832–9.469;P ? 0.001] and HR:3.576 [95% CI:1.613–7.927;P =0.002],respectively).On multivariate analyses,location,tumor size,mitotic count,and both high NLR and PLR were independent prognostic factors of RFS in GIST.Both a high NLR and PLR were significant prognostic factors for GISTs within the National Institutes of Health(NIH)high-risk categories.Conclusions:1.High NLR and PLR were independent prognostic factors of RFS in GIST.2.NLR and PLR would be useful as a preoperative prognostic tool.3.Combining NLR ? PLR and NIH classification criteria can improve theaccuracy of prognosis for patients with GIST.Objective:Recent studies have shown that the neutrophil to lymphocytes ratio is related to the prognosis of patients with gastrointestinal stromal tumors,but it is still controversial.This study was designed to evaluate the prognostic value of NLR in patients with gastrointestinal stromal tumors.Methods:PubMed,Embase,Web of Science,CBM,CNKI,and Wan Fang Data databases were used as the main source to search for the relevant research on the prognosis of patients with NLR and GIST.The search time limit was established until October 31,2018,according to the proposed inclusion criteria.And exclusion criteria,screening for documents that meet Meta analysis criteria.Two investigators independently assessed the quality of the included studies and extracted data.The data were analyzed using STATA 12.0 software.Result:A total of 2,000 patients from 11 studies were included to evaluate the association between NLR and clinical outcome of GIST patients.Preoperative high-level NLR indicated poor RFS/DFS signifcantly(HR=2.33,95%CI:1.50-3.61,P?0.001),but had no impact on OS(P=0.1.5).Conclusion:Preoperative high-level NLR is an independent prognostic factor for RFS/DFS in patients with GIST.Preoperative NLR levels in patients with GIST have a certain significance in judging long-term clinical prognosis.