Predictive Ability Of Preoperative NLR、PLR、LMR And SII In Gastrointestinal Stromal Tumors

Objective: To investigate the value of preoperative Neutrophil to lymphocyte ratio,Platelet lymphocyte ratio,Lymphocyte to monocyte ratio,and Systemic immune inflammatory index in predicting the prognosis of gastrointestinal stromal tumors.Methods: The clinical data of 289 GIST patients admitted in potentially curative resection from January 2017 to January 2019 in the Second Hospital of Hebei Medical University were retrospectively considered.Preoperative peripheral blood cell count of patients was collected to calculate the neutrophil to lymphocyte ratio(NLR),platelet lymphocyte ratio(PLR),Lymphocyte to monocyte ratio(LMR),and Systemic immune inflammatory index(SII).Under the receiver operating characteristic curve(ROC curve)to calculate the best boundary value,and the patients were divided into high value group and low value group respectively.Application of Chi-square test and Rank sum test to compare between groups.Kaplan-Meier survival curves were constructed,and the log-rank test was used to compare survival rate.Univariate and multivariate Cox proportional hazard regression models were performed to identify associations with outcome variables.The area under the ROC curve(AUC)were used to assess the efficiency of independent prognostic factors in predicting the prognosis of patients with gastrointestinal stromal tumors.Results:1.The best threshold values of NLR、PLR、LMR and SII were2.455,204.915,3.015 and 698.700,respectively.With this as the critical point,the four subjects were divided into high value group and low value group.2.The Chi-square test and Rank sum test showed that the risk grading standards,tumor location were significantly positive correlated with NLR、PLR、LMR and SII(P<0.05).3.The Univariate analysis revealed that age,tumor location,tumor size,number of mitotic images,the risk grading standards,the operation,NLR,PLR,LMR,SII and TKI adjuvant therapy were significant prognostic factors(P<0.05).4.COX multivariate analysis revealed staging: the age>60 years,the higher risk grading standards,high PLR levels and high SII levels were independent prognostic factors affecting postoperative RFS in patients.5.The AUC of the ROC curve indicated that the risk grading standards was the best factor for predicting the prognosis of patients with gastrointestinal stromal tumors,the secondary was SII,the third was PLR,and the last was age.Conclusions:1.The NLR,PLR,LMR and SII were found to be correlated with the risk grading standards and tumor location.2.The age,tumor location,tumor size,number of mitotic images,the risk grading standards,the operation,NLR,PLR,LMR,SII and TKI adjuvant therapy were significantly correlated with the prognostic of GIST.3.The age,the risk grading standards,preoperative PLR and SII are the independent prognostic factors for PFS in patients with GIST.The age>60years,the higher risk grading standards,high PLR levels and high II levels exhibited the higher risk of recurrence.