Predictive Value Of Lymphocyte/C-Reactive Protein Ratio(LCR) For Preoperative Tumor Grading And Postoperative Complications In Gastric Cancer Patients Undergoing Robotic Surgery

Objective To investigate the predictive value of the Lymphocyte/ c-reactive protein ratio(LCR)for preoperative tumor grading and postoperative complications in gastric cancer patients undergoing robotic surgery.Methods According to the inclusion and exclusion criteria,146 patients with resectable gastric cancer who underwent robotic radical gastric cancer surgery in the Department of General Surgery of Gansu Provincial People’s Hospital from October 2021 to December 2023 were included through a retrospective study method,and their baseline data,preoperative and postoperative lymphocytes,creactive protein and related blood indices,complications,and tumor pathological characteristics were collected for statistical analysis of data to study and investigate the value of LCR values on preoperative tumor grading and postoperative complication prediction in patients with gastric cancer who underwent robotic surgery.Results Receiver operating haracteristic(ROC)curve analysis of the patient’s tumor T-stage ROC)curve analysis showed that compared to the preoperative Creactive protein to albumin ratio(CAR),Neutrophil to lymphocyte ratio(NLR),Lymphocyte to monocyte ratio(LMR),Platelet to lymphocyte ratio(LMR),and Platelet to lymphocyte ratio(LMR).Lymphocyte to monocyte ratio(LMR),Platelet to lymphocyte ratio(PLR),etc.The area under curve(AUC)of preoperative LCR(95%CI: 0.626-0.816;p<0.001)was the largest(0.626-0.816).,AUC)was the largest(0.721),and patients were grouped according to the best cut-off value of preoperative LCR: patients with LCR≥ 0.9291 were divided into the high LCR group(HLCR),and patients with LCR < 0.9291 were divided into the low LCR group(LLCR).After statistical analysis,in terms of general clinical data,preoperative LCR level was significantly correlated with patients’ BMI and tumor size(p<0.05),with no significant correlation with gender,age,number of lymph nodes dissected,duration of surgery,intraoperative bleeding,and extent of resection(p>0.05),and in terms of tumor pathological characteristics,preoperative LCR level was significantly correlated with patients’ T-stage,N-stage,and lymphovascular invasion(p<0.05),with no significant correlation with degree of differentiation,nerve invasion,and vascular cancer thrombus(p>0.05).The ROC curve analysis of patients’ postoperative complications showed that the AUC of postoperative LCR(95% CI: 0.621-0.842;p<0.001)was the largest(0.731)compared to postoperative CAR,NLR,LMR,PLR,etc,and prognostic nutritional index PNI;according to the postoperative LCR best cut-off value grouped patients: patients with LCR≥0.0101 were divided into the high LCR group(HLCR)and patients with LCR < 0.0101 were divided into the low LCR group(LLCR);statistical analysis showed that the difference in the occurrence of total postoperative complications between the LLCR and HLCR groups was statistically significant(p<0.001),and in the LLCR group The incidence of complications was basically higher in the LLCR group than in the HLCR group.Univariate and multifactorial logistic regression analyses showed that the degree of tumor differentiation was an independent risk factor for the occurrence of postoperative complications(p<0.05).Conclusion Gastric cancer patients with low preoperative LCR had a worse tumor grade than those with high LCR,Low postoperative LCR is a risk factor for the development of postoperative complications in patients.