Clinical Study Of Neutrophil-lymphocyte Ratio In Predicting Diagnosis And Prognostic Evaluation Of Lymph Node Metastasis In Early Gastric Cancer

Objective:To investigate the value of preoperative neutrophil-lymphocyte ratio(NLR)in the prediction,diagnosis and prognosis of lymph node metastasis(LNM)in early gastric cancer(EGC),so as to provide reference for the clinical diagnosis and treatment of EGC.Methods:A total of 134 patients with early gastric cancer who received radical gastrectomy in our hospital from November 2011 to November 2014 were included.Patients’ gender,age,medical history,pathological results of surgical specimens,preoperative platelet-lymphocyte ratio(PLR)and NLR were collected,and independent risk factors affecting lymph node metastasis in EGC patients were analyzed by univariate and logistic multivariate regression models.Receiver operating curve(ROC)was used to analyze the diagnostic value of preoperative NLR in evaluating LNM positivity in EGC patients,and the diagnostic cutoff value was obtained.Patients were divided into low NLR group and high NLR group by diagnostic cutoff value.Statistical methods such as Pearson analysis and Kaplan-Meier(K-M)survival curve were used to analyze the relationship between NLR and clinicoppathological parameters,as well as the effect of NLR on 5-year survival of EGC patients.Results:1)Univariate analysis showed that the depth of tumor invasion,degree of differentiation,lesion size,preoperative PLR and preoperative NLR might affect LNM(P<0.05).2)Logistics multivariate analysis showed that tumor size,depth of invasion,degree of differentiation and preoperative NLR were independent risk factors for LNM in EGC patients((P<0.05).3)ROC curve analysis showed that the cutoff value of preoperative NLR for predicting LNM in EGC patients was 2.295,with sensitivity and specificity of 82.6% and 77.5%,respectively.4)EGC patients were divided into low NLR group(NLR<2.295,90 cases)and high NLR group(NLR≥2.295,44 cases).There were significant differences in age,lesion size and gross tumor type between the two groups(P<0.05).5)Correlation analysis showed that preoperative NLR was positively correlated with tumor size(r=0.645;P<0.001).6)Kaplan-Meier(K-M)survival curve and Log-rank χ~2 test showed that the 5-year survival rate in EGC patients was 90.3%(121/134),and the 5-year survival rate in the low NLR group was significantly higher than that in the high NLR group(94.4%,85/90 vs.81.8%,36/44;Log-rank χ~2= 5.466,P<0.05).Conclusion:Independent risk factors for LNM in EGC patients included: low degree of tumor differentiation,deep invasion,large lesion diameter,and high preoperative NLR.Preoperative NLR can reflect the degree of tumor progression in EGC patients to a certain extent,and has a certain evaluation value for lymph node metastasis,and has a certain predictive value for 5-year survival after surgery.