| Objective: The inflammation and nutritional-based indexes have been reported to correlate with the prognosis of various cancers.However,the prognostic significances of those indexes in gastric cancer remain to be determined.We conducted this study to explore the correlation between combined neutrophil-platelet score(CNPS),systemic immune-inflammation index(SII),prognostic nutrition index(PNI)and lesion severity of gastric cancer and also to analyze their prognostic role in gastric cancer.Methods: All the patients with gastric cancer,who underwent potentially curative resection in The First Affiliated Hospital of Jinan University between October 2011 to December 2016 were considered.Based on inclusion and exclusion criteria,125 gastric cancer patients were collected(experimental group).Meanwhile,80 healthy individuals who visited the physical examination center were selected(control group)by random number table method.Statistical analysis was performed with the SPSS 22.0 software package.These inflammation and nutritional-based indexes were compared between experimental group and control group.The relationships between CNPS,SII,PNI and clinicopathologic factors were analyzed by using the Chi square test or Fisher’s exact test.Kaplan–Meier survival curves were constructed,and the log-rank test was used to compare survival rate.The multicollinearity of concomitant variables in Cox proportional hazards model was diagnosed by collinearity diagnostics.Univariate and multivariate analysis was performed by using the Cox proportional hazards model.Receiver operating characteristic(ROC)curves and area under the ROC curve(AUC)were used to assess the sensitivity and specificity of CNPS,SII and PNI in predicting the prognosis of patients with gastric cancer.For all analyses,the P-values less than 0.05 were considered statistically significant.Results:1.The levels of NLR,PLR and SII in the experimental group were significantly higher than that in control group,while the level of PNI was opposite,the differences were statistically significant(p<0.05).2.The Chi-square test or Fisher’s exact test showed that the depth of invasion,lymph node metastasis,distant metastasis,TNM staging,vascular invasion,albumin,and CA199 were significantly positive correlated with CNPS and SII,while,negatively correlated with PNIin the experimental group(P<0.05).CNPS,SII and PNI were not found to associated with age,tumor site,and differentiation(P>0.05).3.The Kaplan–Meier analysis and log-rank tests revealed significant differences in overall survival(OS)and progression free survival(PFS)among patients with higher and lower CNPS,SII and PNI.The mean OS and PFS were significantly longer for the patients with a lower CNPS or SII,while the mean OS and PFS were considerably longer for the patients with higher PNI(P<0.05).4.The Univariate analysis revealed that CNPS,SII and PNI were significant prognostic factors;meanwhile,The Multivariate analyses showed that OS and PFS were independently associated with the CNPS(all P < 0.05).5.The area under the ROC curve(AUC)of CNPS,SII and PNI were 0.821,0.749 and 0.722(all P =0.000)respectively,these results indicated that CNPS was superior to SII and PNI for predicting OS in patients with gastric cancer.Conclusions:1.The CNPS,SII and PNI were found to be correlated with the depth of invasion,lymph node metastasis,distant metastasis and TNM staging,which indicates that the CNPS,SII and PNI can be used as indicators for evaluating the severity of gastric cancer.2.CNPS is an independent prognostic factor for OS and PFS in patients with gastric cancer,and it exhibited a significantly higher predictive accuracy compared with the SII and PNI. |
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