| BackgroundGastric carcinoma is one of the most common upper gastrointestinal tumors in the world,included China.According to the statistical analysis of the China Cancer Center in2018,the mortality rate of gastric carcinoma is still high,with lung carcinoma in the second place[1].It has been found that the survival rate of patients with gastric carcinoma is still less than 30%[2].At present,TNM stage and histopathology classification and other indexes have been widely confirmed as the factors that affecting the prognosis of patients with gastric carcinoma,However,it is a hot spot to find a more simple and reliable index to comprehensively evaluate prognosis of gastric carconoma.Recently years,relationships between tumor and inflammation have been founded,the ratio of neutrophil to lymphocyte（NLR）is a dynamic serological index reflecting inflammation and immune response,and it could used to be as prognostic factor for the prognosis of various carcinomas.Studies of Chinese and foreign scholars have also confirmed that a higher NLR before operation indicated poor prognosis,but previous studies focused on preoperative NLR levels,however,few reports on the relationship between postoperative and preoperative changes of neutrophil to lymphocyte ratio（NLRc）and prognosis in gastric carcinoma.ObjectiveThe clinicopathological index and follow-up data of 116 patients in gastric carcinoma were analyzed retrospectively,to investigate the relationgship between postoperative and preoperative changes of neutrophils to lymphocytes ratio（Changes of Neutrophils to Lymphocytes Ratio,NLRc）and prognosis in gastric carcinoma,it is important to provide clinical basis for evaluating early postoperative recurrence and predict the prognosis of gastric carcinoma,providing more accurate guidances of comprehensive treatment for patients with gastric carcinoma.MethodsThe blood routine results of fasting peripheral blood of 116 patients in gastric carcinoma were collected in one week during in hospital and one month after operation（3-5weeks after surgery,before the first chemotherapy）,NLR（Neutrophils to Lymphocytes Ratio）is Ratio of neutrophils to lymphocytes in peripheral blood,NLR of 1 week before operation and 1 month after surgery were recorded and calculated,NLRc（Changes of Neutrophils to Lymphocytes Ratio）was defined as postoperative NLR:preoperative NLR,patients were divided into NLRc<1group and NLRc≥1group according to NLRc.Statistical analysis was performed using SPSS 21.0 statistic Software,the measurement data were described by mean±standard deviation（（?）±s）;enumeration data（%）were described by ratio,and the rate between groups was compared byχ2 test or rank sum test.Univariate survival analysis was performed by Kaplan-Meier method,and Log-rank test was used for comparison of survival rates between groups;Cox proportional hazard regression model was used to analyze the prognostic factors.P values of<0.05 has statistically significant difference.Inspection levelα=0.05.ResultsAnalysis result showed that NLRc was not associated with sex,age（P>0.05）,NLRc was associated with the tumor diameter and depth of infiltration and lymph node metastasis（P<0.05）.Survival analysis showed that the 1-,3-year survival rates of NLRc<1group were 93.6%,44.1%,median survival time was 23.0 months（95%CI 22.5～23.5months）,the 1-,3-year survival rates of NLRc≥1group were 47.8%,16.5%,median survival time was 10.0 months（95%CI 9.8～10.2 months）,the difference was statistically significant by Log-rank test（χ2=45.336,P<0.001）.Univariate survival analysis showed that NLRc,tumor diameter,depth of invasion and lymph node metastasis were the prognostic factors of gastric carcinoma（all P<0.05）;Multivariate regression analysis showed that NLRc,tumor diameter,depth of invasion and lymph node metastasis were independent factors affecting the prognosis of patients in gastric carcinoma（all P<0.05）.ConclusionNLRc is associated with the poor prognosis of gastric carcinoma,may be an independent factor affecting the prognosis in gastric carcinoma. |
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