Changes In Neutrophil/lymphocyte And Platelet Count Corrlate With Chemotherapy Response And Prediction Of Progonosis In Patients With Stage Ⅳ Gastric Cancer

Objective: To analyze the predictive value of curative effect of net rophil/ lymphocytes ratio and platelet count before and after 2 cycles of chemotherapy in patientswitn stage IV gastric cancer and its influence on prognosis.Methods: A retrospective study was conducted to collect 897 patie nts with stage IV gastric cancer treated in our hospital from February 2010 to February 2015.260 patients were selected according to the inclu sion criteria.The basic clinicopathological data of patients were collect ed including gender,age,pathological type,location of tumors,dis-tant metastasis,Borrmann classification and Neutrophil-to-lymphocyte rat-io b efore chemotherapy(NLR1),platelet before chemotherapy(NLR1),Neutro phil-to-lymphocyte rat-io after chemotherapy(NLR2),platelet after chemotherapy(PLT2),efficacy evaluation and overall survival OS.The receiver operating curve ROC was drawn to determine the optimal criti cal value of NLR.The cases were grouped according to the best critical value of NLR and the high limit of PLT normal value.chi-square test with SPSS21 statistical software was used to analyze the difference of clinicopathological characteristics between different NLR and PLT gro ups before chemotherapy,and the relationship between NLR and PLT changes before and after chemotherapy and the efficacy of chemotherapy.Log-rank test and Cox risk regression were used to analyze the predictive value of clinicopathological factors for OS in patients with stage IV gastric cancer,and Kaplan-Merier survival method was used to draw survival curve of patients with gastric cancer,P < 0.05 has statistical s ignificance.Result:1.ROC 3 was the best NLR value.The comparison of clinicopathological characteristics between high and low NLR1 gastric cancer patients showed that there were differences in pathological type,Borramn type,distant metastasis and objective remission rate(P=0.001,P=0.000,P=0.000,P=0.006).2.Comparisons of clinicopathological features between patients with high and low PLT1 gastric cancer showed that there were differences in Borramn classification(X2 = 2.688,P = 0.000).3.The changes of NLR and PLT before and after chemotherapy have predictive value for the curative effect of chemotherapy,as follows: after chemotherapy,the objective remission rate(X2 = 5.356,P = 0.021)and disease control rate(X2 = 11.824,P = 0.001)of different NLR2 groups have statistical difference;after chemotherapy,the disease control rate(X2 = 5.718,P = 0.017)of different PLT2 groups have statistical difference.4.Univariate analysis of OS: pathological type,Borramn typing,NLR before chemotherapy,NLR after chemotherapy,NLR after chemotherapy,and the first evaluation of efficacy have predictive value for OS(P = 0.000,P = 0.003,P = 0.047,P = 0.005,P = 0.000).5.Multivariate regression analysis of OS: Pathological type(P=0.000)and efficacy evaluation(P=0.000)were independent risk factors affecting the prognosis of stage IV gastric cancer.Conclusion:1.Low levels of NLR before chemotherapy are associated with clinicopathological features such as organ-free metastasis,Borramn type I and II,tubular adenocarcinoma and papillary carcinoma.2.The changes of NLR and PLT before and after chemotherapy are related to the curative effect.3.Pathological types and the results of the first therapeutic evaluation are independent predictors of OS in patients with stage IV gastric cancer,suggesting that OS may be a simple and effective prognostic indicator.