|Table of Contents|

Prediction of the prognosis of gastric cancer patients based on the combination of preoperative and postoperative neutrophil-lymphocyte ratios

Journal Of Modern Oncology[ISSN:1672-4992/CN:61-1415/R]

Issue:
2024 04
Page:
672-678
Research Field:
Publishing date:

Info

Title:
Prediction of the prognosis of gastric cancer patients based on the combination of preoperative and postoperative neutrophil-lymphocyte ratios
Author(s):
ZHANG Maolin1; YANG Fang2; JIN Xiangren3; WANG Yang3; YAN Zhiqiang3
1.Guizhou Medical University，Guizhou Guiyang 550004,China；2.Laboratory Department；3.Gastrointestinal Surgery Department,Affiliated Hospital of Guizhou Medical University,Guizhou Guiyang 550001，China.
Keywords:
gastric cancer; NLR; prognostic model; nomogram
PACS:
R735.2
DOI:
10.3969/j.issn.1672-4992.2024.04.015
Abstract:
Objective:To evaluate the prognostic predictive value of the combination of preoperative and postoperative neutrophil to lymphocyte ratio (NLR) in patients with gastric cancer.Methods:A total of 133 newly diagnosed gastric cancer patients who underwent radical surgery in the gastrointestinal surgery department,Affiliated Hospital of Guizhou Medical University from January 1,2015 to April 1,2018 were retrospectively collected.Preoperative NLR and postoperative NLR were collected,and the receiver operating characteristic curve (ROC) was used to analyze and determine the optimal cut-off value of inflammation indicators.According to the optimal cut-off value,all patients were divided into preoperative NLR and postoperative NLR low group,preoperative NLR low or postoperative NLR low group,and preoperative NLR and postoperative NLR high group.Kaplan-Meier method was used to analyze overall survival (OS).Independent risk factors for prognosis were analyzed by Cox proportional hazard regression model.The nomogram model was built by R Studio，and the efficacy of the prediction models was evaluated.Results:The predictive efficacy of preoperative NLR combined with postoperative NLR for gastric cancer patients (AUC=0.706 8) was better than that of preoperative NLR alone (AUC=0.664 3) or postoperative NLR alone (AUC=0.593 3).The median survival time of patients with low preoperative NLR and postoperative NLR was 61 months,and the 5-year survival rate was 62.07%.The median survival time was 54 months and the 5-year survival rate was 48.15% in the preoperative NLR low or postoperative NLR low group.The median survival time was 12 months and the 5-year survival rate was 22% in the high preoperative NLR and postoperative NLR group.The prognosis was the worst in the high preoperative NLR and postoperative NLR group (P＜0.001).Cox regression analysis showed that surgical method (HR=0.465,P=0.001),TNM stage (HR=3.387,P=0.006) and preoperative NLR combined with postoperative NLR (HR=2.091,P=0.002) were independent risk factors for prognosis of gastric cancer patients.The prediction of 3-year prognosis (AUC=0.859 3) and 5-year prognosis (AUC=0.885 2) was better than that of preoperative NLR (AUC=0.664 3) and postoperative NLR (AUC=0.593 3).The calibration curve suggested that the model had a high consistency,and the decision curve showed a good clinical benefit from the model.Conclusion:Preoperative NLR combined with postoperative NLR is an important prognostic factor in gastric cancer patients.Patients in high group of both preoperative NLR and postoperative NLR had a poor prognosis.The nomogram graph model based on these two inflammatory markers and clinicopathological features can be used to evaluate the prognosis of gastric cancer patients,with better predictive power than preoperative NLR and postoperative NLR alone.

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Memo

Memo:
贵州省卫生健康委科学技术基金项目（编号：gzwkj2021-168）;贵州医科大学博士科研启动基金项目（编号：gyfybsky-2021-31）
Last Update: 1900-01-01