Preoperative Neutrophil To Lymphocyte Ratio (NLR) On The Prognosis Of Patients With Gastric Cancer

Objective:The aim of this study was to study the relationship between preoperative NLR in patients with gastric cancer and pathological results and prognosis factors,and to investigate the value of NLR on the prognosis of patients with gastric carcinoma.Methods:102 patients with gastric cancer, received curative resection in our hospital from 2007 September to 2009 December, were collected to do retrospective analysis. A total of 67 men and 35 women, with a mean age of 61.5 years. NLR was calculated from neutrophil and lymphocyte on routine blood tests taken before surgery. The depth of tumor invasion, lymph node staging, TNM staging, tumor size, tumor differentiation,age and gender were statistically analyzed,we performed univariate analysis for preoperative NLR of different factors,and then further using multivariate analysis to explore the factors associated with NLR.we use survival analysis to estimate the survival rate, compare the difference clinical factors between the groups of patient survival by the Kaplan-Meier method, and analysis the relationship between the factors and 5 years survival rate by using COX regression methods.Results:1. We performed univariate analysis for the relationship between preoperative NLR and the factors of patients, the difference of preoperative NLR has statistics significance in the depth of tumor invasion, lymph node staging and TNM staging(P<0.05).The later stages, NLR mean had a higher value.And then these factors including sex, age, tumor size,and tumor differentiation have no statistics significance.Multivariate analysis reveal that T staging, N staging, TNM staging has the correlation with preoperative NLR (P<0.05).2.Taking NLR=3 as the cutoff value, the patients were divided into high NLR group and low NLR group.We use Kaplan-Meier to draw the two groups of patients with 5 year survival curve,and Survival analysis to estimate survival rate.In 102 patients,5 years survival rate of low NLR patients was 56%,5 years survival rate of high NLR group patients was 23%, the survival rate of the patients in the two groups were compared, the log rank test showed that between the two groups survival rate difference was statistically significant (P< 0.05).COX regression model suggested:preoperative NLR, depth of tumor invasion, lymph node metastasis staging and TNM staging were independent prognostic factors in patients with gastric carcinoma after operation.Conclusion:1.the preoperative NLR increased gradually along with the increasing depth of tumor invasion, rising metastasis staging and progressing TNM staging.The later stages, NLR mean had a higher value.Preoperative elevated NLR has value to predict tumor progression in a certain extent.2.we can use preoperative NLR on prognosis prediction,the prognosis of preoperative NLR≥3 groups of patients with gastric carcinoma is better than the NLR <3 of patients, The preoperative NLR ratio has a certain value for predicting the prognosis of patients with gastric cancer.