| Objective:To evaluate the influence and value of the combined effect of preoperative CEA and SIR on the prognosis of gastric cancer patients undergoing surgery.Methods: A total of 803 Patients who underwent radical gastrectomy in Qinghai University Affiliated Hospital from January 2012 to December 2016 were included as training set.Multivariable Cox proportional hazard regression was used to identify associations with outcome of gastric cancer(GC).CNLR was established by combining CEA and the neutrophils to lymphocytes ratio(NLR,a typical parameter in SIR)to generate a novel prognostic score system,and its prognostic value was externally validated.Results: A total of 803 patients in the experimental group were included in the analysis.Univariate Cox regression analysis showed that preoperative CEA and SIR,including NLR,PLR and LMR,were closely related to the prognosis(all P < 0.05).Other relevant clinicopathological data also included age,tumor size,degree of differentiation,vascular invasion,pTNM stage and albumin(all P < 0.05).Multivariate analysis showed that preoperative CEA and NLR were independent predictors of gastric cancer Other clinicopathological data included age,pTNM stage and neurovascular invasion(all P < 0.05);Patients with higher CNLR had poor prognosis than those with lower CNLR(P < 0.05).Multivariate analysis showed that CNLR was an independent prognostic factor(P < 0.05).Incorporation of the CNLR into a prognostic model including age and TNM stage generated a nomogram,which predicted accurately 3-and 5-year survival for GC patients.And similar results were obtained in the external validation set.Conclusion: The CNLR prognostic scoring system established by combining CEA and NLR is an independent prognostic factor for GC,which can be incorporated into the traditional TNM staging to improve the prediction of long-term survival outcomes. |
