Study On The Relationship Between Peripheral Lymphocyte-to-white Blood Cell Ratio And Clinicopatholo Gy And Prognosis In Gastric Cancer Patients

Objective A large number of studies show that the immune system plays a crucial role in the occurrence and progression of cancer.The expression of immune cells in multiple malignancies is associated with the prognosis of patients.The increase of neutrophil-to-lymphocyte ratio(NLR)in peripheral blood of patients is associated with the poor prognosis of multiple malignancies.However,the comparison of the other parameters in the peripheral blood and the value of prognosis in the peripheral blood before operation are rare and controversial.On the basis of previous studies,this study explored the relationship between the monitoring indexes of peripheral blood and the clinical parameters and prognosis of gastric cancer patients.Methods Clinico-pathological data of 257 patients with gastric cancer in the First Affiliated Hospital of Anhui Medical University between September 2011 and December 2011 was analyzed retrospectively in this study.The optimal cutoff values of NLR,platelet-to-lymphocyte ratio(PLR),monocyte-to-lymphocyte ratio(MLR),neutrophil-to-white blood cell ratio(NWR),lymphocyte-to-white blood cell ratio(LWR)and monocyte-to-white blood cell ratio(MWR)were determined by receiver operating characteristic(ROC)curve,and the patients were divided into high and low groups.Kaplan-meier method was used to estimate the overall survival(OS),and different groups was compared with the Log rank test.Moreover,univariate andmultivariate models were used to analyse the prognosis factor of gastric cancer patients.Results The tumor infiltration depth,lymph node metastasis and TNM stage were associated with high NLR group.The tumor infiltration depth and TNM stage were associated with high NWR group.High NLR,high PLR,high MLR,high NWR,high MWR and low LWR were all associated with poor prognosis of gastric cancer(P <0.05),But only LWR was an independent Prognostic Predictors(HR=0.357,95%CI:0.258~0.494,P<0.05).Conclusion 1.preoperative NLR was more closely related to the pathological features of gastric cancer than other inflammatory markers.2.High NLR,high MLR,high PLR,high NWR,high MWR and low LWR are associated with poor prognosis of gastric cancer,and LWR is an independent prognostic risk factor for gastric cancer.