| Background and purpose:Studies have found that inflammation and blood coagulation are closely related to the occurrence and prognosis of tumors,and there is a close relationship between inflammation and blood coagulation in the tumor microenvironment,which together play a pivotal role in tumor growth,invasion,angiogenesis and metastasis.Studies have shown that preoperative peripheral blood inflammation indicators of NLR,LMR,PLR and coagulation index FIB are closely related to the pathological features and prognosis of solid tumors such as colorectal cancer and lung cancer.However,there are few studies on the relationship between these indicators and the clinicopathological characteristics of gastric cancer.This study was aim to investigate the correlation between preoperative inflammatory markers(NLR,LMR,PLR)and coagulation markers(FIB)and pathological features and prognosis of gastric cancer.Methods:From January 2012 to October 2018,262 patients with gastric cancer who were admitted to zhongshan hospital affiliated to dalian university for explicit diagnosis and radical resection were selected according to inclusion criteria and exclusion criteria.Among them,185 cases(70.6%)of male and 77 cases(29.4%)of female,the average age was 66.2 years(minimum 25 years and maximum 87 years old).Clinical data collection:1.Preoperative blood routine: neutrophil(Neu),platelet(PLT),lymphocyte(Lym),mononuclear cell(Mo)count,NLR value,LMR value and PLR value were obtained.2.Preoperative coagulation function results: fibrinogen.3.Pathological data: tumor size,invasion depth,differentiation type,lymph node metastases,nerve and vascular invasion.4.General information: gender and age.SPSS19 software was used to analyze.The median of NLR was 2.2,the median of PLR was 136.5,the median of LMR was 5.3,and the median of FIB was 3.1,as the critical values respectively,the patients were divided into two groups,high and low.The differences in clinicopathological features between the two groups were analyzed.To determine the specific correlation of NLR,PLR,LMR and FIB with the clinicopathological characteristics of gastric cancer patients.NLR,PLR,LMR and FIB values were combined,and patients were divided into four groups according to their respective critical values,the differences in tumor invasion depth,lymph node metastasis,tumor size and TNM stage were compared between the four groups.Patients who were followed up for one year from 262 patients were divided into recurrent metastasis or death group and survival group,the differences of NLR,PLR,LMR and FIB values were compared between the two groups.Results:1.The relationship between the NLR value of the preoperative gastric cancer patient and the clinical pathologic features: The χ2 test results showed that the difference in invasion depth(P=0.011),lymph node metastasis(P=0.043),TNM stage(P=0.002)and the size of tumor(P=0.000)between the two groups were statistically significant(P< 0.05);the difference in gender(P=0.684),age(P=0.094)and tumor differentiation degree(P=0.621)between the two groups were no statistically significant(P>0.05).Spearman correlation analysis showed that preoperative NLR value was positively correlated with tumor size,invasion depth,lymph node metastases and TNM stage.There was no correlation with gender,age,differentiation degree,vascular invasion and nerve invasion.2.The relationship between the PLR value of the preoperative gastric cancer patient and the clinical pathologic features: The χ2 test results showed that the difference in invasion depth(P = 0.000),lymph node metastasis(P = 0.005),TNMstage(P = 0.000)and the size of tumor(P = 0.000)between the two groups were statistically significant(P< 0.05);the difference in gender(P=0.078),age(P=0.402)and tumor differentiation degree(P=0.322)between the two groups were no statistically significant(P>0.05).Spearman correlation analysis showed that preoperative PLR value was positively correlated with tumor size,invasion depth,lymph node metastases and TNM stage.There was no correlation with gender,age,differentiation degree,vascular invasion and nerve invasion.3.The relationship between the LMR value of the preoperative gastric cancer patient and the clinical pathologic features: The χ2 test results showed that the difference in gender(P=0.037),invasion depth(P=0.000),lymph node metastasis(P=0.007),TNM stage(P=0.000)and the size of tumor(P=0.016)between the two groups were statistically significant(P< 0.05);the difference in age(P=0.256)and tumor differentiation degree(P=0.226)between the two groups were no statistically significant(P>0.05).Spearman correlation analysis showed that preoperative LMR was negatively correlated with tumor size,invasion depth,lymph node metastases,TNM stage,vascular invasion and gender(male).There was no correlation with age,differentiation degree,and nerve invasion.4.The relationship between the FIB value of the preoperative gastric cancer patient and the clinical pathologic features: The χ2 test results showed that the difference in invasion depth(P=0.039),lymph node metastasis(P=0.003),TNM stage(P=0.011),the size of tumor(P=0.000)and differentiation degree(P=0.045)between the two groups were statistically significant(P< 0.05);the difference in gender(P=0.649)and age(P=0.391)between the two groups were no statistically significant(P>0.05).Spearman correlation analysis showed that preoperative FIB value was positively correlated with tumor size,lymph node metastases and TNM stage.There was no correlation with gender,age,invasion depth,differentiation degree,vascular invasion and nerve invasion.5.Preoperative NLR,PLR,LMR combined with FIB grouping showed differences in pathological characteristics between groups: the difference in invasion depth((P= 0.024),lymph node metastasis(P = 0.010),tumor size(P = 0.000)andTNM stage(P = 0.003)of the patients in the high NLR-high FIB,high NLR-low FIB,low NLR-high FIB,low NLR-low FIB groups were statistically significant(P<0.05).The difference in invasion depth(P= 0.000),lymph node metastasis(P = 0.002),tumor size(P = 0.000)and TNM stage(P = 0.000)of the patients in the high PLR-high FIB,high PLR-low FIB,low PLR-high FIB,low PLR-low FIB groups were statistically significant(P<0.05).The difference in invasion depth((P= 0.001),lymph node metastasis(P = 0.001),tumor size(P = 0.000)and TNM stage(P = 0.000)of the patients in the high LMR-high FIB,high LMR-low FIB,low LMR-high FIB,low LMR-low FIB groups were statistically significant(P<0.05).6.The relationship between preoperative NLR,PLR,LMR and FIB values and early prognosis of patients: 27 patients(22.3%)in the recurrence metastasis or death group and 94 patients(77.7%)in the survival group,the difference in NLR(2.94±1.52 vs 2.23±0.95,P=0.009),LMR(5.44±3.52 vs 6.60±3.29,P=0.042),PLR(196.82±153.57 vs 134.37±54.40,P=0.002)and FIB(3.47±0.83 vs 3.10±0.70,P=0.044)between the two groups were statistically significant(P < 0.05).Conclusion:1.Preoperative peripheral blood NLR,PLR,LMR and FIB values were correlated with the clinicopathological characteristics of gastric cancer.2.Preoperative high NLR,PLR,FIB,and low LMR values suggest possibility of recurrence metastasis or death in the early postoperative period,with poor prognosis.3.The above indicators could be used as a simple and economical biological indicator to preliminarily evaluate the progress and early prognosis of gastric cancer,to guide individualized therapy. |
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