Retrospective Study
Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. May 28, 2015; 21(20): 6280-6286
Published online May 28, 2015. doi: 10.3748/wjg.v21.i20.6280
Significance of the preoperative neutrophil-to-lymphocyte ratio in the prognosis of patients with gastric cancer
Liang Yu, Cheng-Yu Lv, Ai-Hua Yuan, Wei Chen, An-Wei Wu
Liang Yu, Cheng-Yu Lv, Ai-Hua Yuan, Wei Chen, An-Wei Wu, Department of General Surgery, Nanjing First Hospital, Nanjing Medical University, Nanjing 210006, Jiangsu Province, China
Author contributions: Lv CY designed the research; Yu L and Wu AW performed the research; Yuan AH and Che W carried out the data collection and analysis; Yu L drafted the manuscript; Lv CY revised the manuscript critically for important intellectual content.
Supported by Nanjing Science and Technology Project, No. 201106016.
Ethics approval: The study was reviewed and approved by the Nanjing First Hospital, Nanjing Medical University Institutional Review Board.
Informed consent: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest: The authors declare that there is no conflict of interest to disclose.
Data sharing: No additional data are available.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Cheng-Yu Lv, Professor, Department of General Surgery, Nanjing First Hospital, Nanjing Medical University, No. 68 Changle Road, Nanjing 210006, Jiangsu Province, China. lcy_1234@aliyun.com
Telephone: +86-25-52271070 Fax: +86-25-52271081
Received: November 30, 2014
Peer-review started: November 30, 2014
First decision: January 8, 2015
Revised: February 2, 2015
Accepted: March 18, 2015
Article in press: March 19, 2015
Published online: May 28, 2015
Abstract

AIM: To investigate the significance of the preoperative neutrophil-to-lymphocyte ratio (NLR) in the prognosis of patients with gastric cancer (GC).

METHODS: The clinical data of 291 GC patients were analysed retrospectively; these patients were divided into two groups according to their preoperative NLR: a high-NLR group (NLR ≥ 3.5, 131 cases) and a low-NLR group (NLR < 3.5, 160 cases). The clinicopathological characteristics and five-year survival rates of the two groups were compared. The NLR and other clinicopathological factors were subjected to univariate and multivariate survival analysis to evaluate the effects of the NLR on the prognosis of GC patients.

RESULTS: The lowest preoperative NLR among the 291 patients was 0.56, whereas the highest preoperative NLR was 74.5. The mean preoperative NLR was 5.99 ± 8.98. Age, tumour size, T staging, tumour-node-metastasis (TNM) staging and platelet count were significantly different between the high- and low-NLR groups (P < 0.05). The five-year survival rate of the high-NLR group was 17.0%, which was significantly lower than that of the low-NLR group (43.6%; 17.0% vs 43.6%, P < 0.05). The univariate analysis results showed that the five-year survival rate was related to age, tumour size, T staging, N staging, TNM staging, carcinoembryonic antigen value and NLR (P < 0.05). Multivariate analysis results showed that the NLR was an independent risk factor that likely affected the five-year survival rate of GC patients (P = 0.003, HR = 0.626, 95%CI: 0.460-0.852).

CONCLUSION: The preoperative NLR could be used as a prognostic factor for GC patients; in particular, a high NLR corresponded to poor prognosis of GC patients.

Keywords: Gastric cancer, Neutrophil-to-lymphocyte ratio, Prognosis, Inflammation, Survival rate

Core tip: This research preliminarily investigated the relationship between the preoperative neutrophil-to-lymphocyte ratio (NLR) and gastric cancer. The results revealed that a high NLR corresponded to poor prognosis of gastric cancer patients. Furthermore, preoperative NLR could be used as a prognostic factor for these patients.