Relationship Between NLR,LMR,RDW And PDW In Peripheral Blood And Clinicopathological Features And Prognosis Of Advanced Metastatic Gastric Cancer

ObjectiveTo study the relationship between the clinicopathological characteristics and prognosis of the ratio of the number of neutrophils to the number of lymphocytes(NLR),the ratio of the number of lymphocytes to the number of monocytes(LMR),the distribution width of red blood cells(RDW)and the distribution width of platelets(PDW),and to explore whether the above indexes can predict the prognosis of the late metastatic gastric cancer.MethodsThe clinicopathological data of 151 patients with advanced metastatic gastric cancer before treatment were collected and followed up to obtain the survival time.SPSS statistics 22.0 statistical software was used to process the data,nonparametric rank sum was used to test the difference between test groups,Spearman rank correlation was used to analyze the correlation;Kaplan Meier method was used to analyze the survival analysis,log rank test was used,Cox risk regression model was used for multivariate analysis,and P < 0.05 was set as the difference of statistical significance.Results1.Before treatment,NLR was correlated with gender(z =-2.092,P =0.036),ascites(z =-4.062,P = 0.000),number of distant metastasis organs(z =15.308,P = 0.000),CA125(r = 0.566,P = 0.000).The results of survival analysis indicate that the OS of low NLR was better than high NLR,The median OS of low NLR and high NLR group was 15.67 months and 9.26 months,respectively,the difference was statistically significant(P = 0.001).The results of multivariate analysis showed that NLR(HR = 1.618,P = 0.037),lymph node metastasis(HR = 1.732,P = 0.012),treatment cycle number(HR = 0.620,P =0.000)were independent risk factors for advanced metastatic gastric cancer2.Before treatment,LMR was correlated with ascites(z =-2.360,P =0.018),number of distant metastasis organs(z = 14.386,P = 0.001),lymph node metastasis(z =-2.573,P = 0.010),CA125(r =-0.454,P = 0.000).Survival analysis showed that the OS of high LMR was better than that of low LMR,The median OS of low LMR and high LMR were 9.95 months and 17.51 months,respectively,with statistical significance(P = 0.022).3.Before treatment,RDW was correlated with ascites(z =-2.668,P =0.048),CA125(r = 0.209,P = 0.011),CA199(r = 0.261,P = 0.001).Survival analysis showed that the OS of low RDW is better than that of high RDW,the median OS of low RDW and high RDW groups were 13.01 months and 8.9months,respectively,with statistical significance(P = 0.004).4.Before treatment,PDW was significantly correlated with tissue infiltration(z =-2.333,P = 0.020)and lymph node metastasis(z =-2.387,P =0.017).No significant relationship between PDW and prognosis of advanced metastatic gastric cancer was found in survival analysis.Conclusion1.NLR was related to sex,ascites,number of distant metastasis organs and CA125.In addition,NLR was also related to OS of patients.OS of low NLR was better.2.LMR was related to ascites,number of distant metastasis organs,lymph node metastasis and CA125.LMR is also related to OS of patients,and OS of high LMR is better.3.RDW is related to ascites as well as OS of advanced metastatic gastric cancer.The OS of low RDW is better.4.PDW is related to tissue infiltration and lymph node metastasis,but not to OS of advanced metastatic gastric cancer.5.NLR,lymph node metastasis and the number of treatment cycles are independent risk factors for the prognosis of advanced metastatic gastric cancer.