Correlation Between Preoperative NLR And PLR With Lymph Node Metastasis Of Gastric Cancer

Objective:The objective of our study was to investigate the correlation between neutrophil-lymphocyte ratio(NLR)and platelet-lymphocyte ratio(PLR)with the pathological features of gastric cancer,also to assess the predictive value of the preoperative NLR and PLR on the lymph node metastasis in gastric cancer patients.Methods:The retrospective casecontrol study was conducted.From June 2014 to December 2016,A total of 150 patients who underwent gastrictomy in Shanxi Provincial People’s Hospital were enrolled in this study.Basic information includes gender and age,The clinical data included absolute neutrophil count(NEU),absolute lymphocyte count(LYM),platelet absolute count(PLT)in the peripheral blood.and calculate neutrophil-lymphocyte ratio(NLR),and platelet-lymphocyte ratio(PLR);pathologic parameters included cancer location,tumor size,pathological type,histological differentiation,depth of tumor invasion,lymph node(LN)metastasis,and TNM stage.The clinical utility of the NLR and PLR was evaluated by receiver operating characteristic(ROC)curves,the features of clinicopathological and categorical variables associated with NLR or PLR were analyzed using the χ2-test.which was also used for univariate analysis of LN metastasis.The logistic analysis was used to identify the independent parameters associated with LN metastasis.Results:The patients consisted of 98 men and 52 women,with a median age of 59 years(range,31–84years).83 patients evidenced tumor sizes of ≥ 4 cm.About 68 patients disease were located in the gastric antrum.Histology results showed that the majority of patients had poorly differentiated(113,75.33%),adenocarcinoma accounts for about 136.The depth of tumor invasion was T1-T2 in 33 patients,T3-T4 in 117.LN metastasis was detected in 102 patients.The postoperative stages of the patients were I-II,III-IV in 44 and 106 patients,respectively.The results showed that the ideal cutoff values for predicting LN metastasis were 1.96 for NLR and 119.59 for PLR according to the ROC curve.Clinicopathologic features of gastric cancer associated with preoperative NLR and PLR were further analyzed.the metastatic ratio of LNs were statistically higher in high PLR and NLR(both P< 0.005)groups.With respect to the other clinicopathologic characteristics examined,high NLR was associated significantly with old age,larger tumor size,depth of invasion,higher node status,and advanced TNM stage(all P<0.005).PLR was significantly increased with old age(P= 0.010),depth of invasion(P= 0.009),advanced TNM stage(P= 0.039),high node status(P=0.021),and large tumor size(P=0.014).No significant difference was observed in our study in terms of gender,location of tumor and histological type(P> 0.05).Multivariate analyses showed that depth of invasion,poorly differentiated type and tumor size are associated significantly with LN metastasis.They are independent risk factors for lymph node metastasis.Preoperative high NLR,high PLR can suggest a greater risk of lymph node metastasis.Conclusion:In patients with gastric cancer,NLR and PLR are important biological markers associated with tumor size,depth of invasion,lymphatic metastasis and TNM staging.Preoperative NLR and PLR may evaluate status of nodal involvement.