Evaluation Value Of Preoperative Peripheral Blood NLR And PLR On Prognosis Of Type ? G-NENs

Objective At present,there are few studies on gastric neuroendocrine tumors(g-NENs)at home and abroad.In this study,the clinicopathological and postoperative follow-up data of type IV g-nens patients were collected to investigate the prognostic value of preoperative peripheral blood NLR(neutrophil to lymphocyte ratio)and PLR(platelet to lymphocyte ratio)in type IV g-nens.Methods The clinicopathological and postoperative follow-up data of 141 patients with type IV g-nens who underwent D2 radical gastrectomy in Anhui Provincial Hospital from January 2011 to June 2018 were collected.According to the inclusion exclusion criteria,the clinicopathological data of 141 patients with type IV g-nens were analyzed,and the cutoff value was determined by ROC curve for dividing NLR and PLR into the high and the low groups.The difference between the high and the low groups were compared by chi-square test and U test.The Kaplan-Meier method was used to calculate the overall survival rate of postoperative patients.Log-rank test was used for single factor and COX regression model was used for multiple factors,which analyze risk factors affecting patient prognosis,all the results were statistically significant(P < 0.05).Results Excluding patients who were lost to follow-up,a total of 141 patients were included in the survival analysis,coming to conclusion:(1)According to the ROC curve,when AUC is the largest,the corresponding cutoff values of NLR and PLR are 2.51 and 135,respectively,including 57 cases(40.4%)in high NLR group,84 cases(59.6%)in low NLR group,81 cases(57.4%)in high PLR group and 60 cases(42.6%)in low PLR group.There was significant difference in survival between the high and low NLR group and the high and low PLR group(P <0.001).58 patients died of type IV g-nens,83 of them have survived so far,with a follow-up period of 3-93 months.The overall survival rates of 1,3 and 5 years after operation were 82%,56% and 40%,respectively.(2)Single factor analysis showed that tumor size(P = 0.025),vascular involvement(P= 0.005),lymph node stage(P = 0.006),lymph node metastasis rate(P < 0.001),TNM stage(P < 0.001),NLR(P < 0.001)and PLR(P < 0.001)were the risk factors affecting the prognosis of type IV g-nens.The indexes with statistical significance of single factor analysis were included in the multi factor test analysis.The results showed that lymph node metastasis rate(P = 0.039),NLR(P < 0.001)and PLR(P = 0.002)may be independent risk factors for the prognosis of type IV g-nens.Conclusion According to the statistical results,tumor size,vascular involvement,lymph node stage,lymph node metastasis rate,TNM stage,NLR and PLR may be the risk factors affecting the prognosis of type IV g-nens patients.Preoperative peripheral blood NLR and PLR may be used to evaluate the prognosis of type IV g-nens patients,and may also be the independent risk factors affecting the overall survival rate of the prognosis.