Correlation Clinical Study Of Preoperative Neutrophil Lymphocyte Ratio In Gastric Cancer Patients With The Lymphnode Metastasis

Objective: To explore and analyze neutrophil lymphocyte ratio (NLR) in preoperativegastric cancer patients with the lymphnode metastasis, thus to guide the lymph-adenectomy in stomach gastrectomy and reduce the damage of local immunity.Methods: The clinical and pathological data of244patients with gastric cancer,received curative resection in our hospital from January2006to December2008, wereanalyzed retrospectively. With184men (75.4%) and60women (24.6%), a mean age of58.3years(29years-85years). NLR was calculated from neutrophil and lymphocytecounts on routine blood tests taken prior to surgery, with NLR<4and NLR≥4wereclassified as low and high NLR group. To calculate the rate of lymph node metastasisand the resected lymph nodes, with the number of resected lymph nodes were classifiedas≥15and <15group. On the basis of clinicopathological stages, type of Borrmann’s,site and maximum diameter of gastric cancer along with the state of lymph nodemetastasis in carcinoma of different region of the stomach, to analyze the prognosticsignificance in relation to the NLR together with various clinicopathological factors.Results:1. The total rate of lymph node metastasis in NLR≥4were significantly higherthan in NLR<4(P<0.05).2. Multivariate analysis of clinicopathological factors affectingNLR revealed that Clinicopathological stages, type of Borrmann’s, site and maximumdiameter of gastric cancer were significant risk factors for increased NLR. NLRincreased successively in carcinoma of early, middle and late stages (P<0.05), the rateof the infiltrative tumor (Borrmann Ⅲ, Ⅳ) was significantly higher.3. The number ofresected lymphnodes in high NLR group was significantly higher than which in lowNLR group (P<0.05).4. Both the5-year survival (32%VS54%, P<0.05) patients witha high NLR was significantly worse than that with a low NLR. Univariate analysesrevealed high NLR, depth of tumor, positive lymphnodes, and distant metastasis weresignificant risk factors for reduced survival. Conclusion:1. Preoperative NLR of gastric cancer patients is a biomarker which can beused to forecast lymphnode metastasis, identify lymphnode staging to makepreoperative diagnose more accurate.2. Preoperative NLR is quite helpful to make thedissection range and amount clear to avoid excessive or deficiency of lymphnodedissection.3. As an independent risk factor, NLR can help to prognosis postoperativeoutcome. Higher NLR indicate bad outcome.4. NLR is an important factor to evaluateimmune function and also a convenient biomarker for cancer state.