Diagnostic Value Of The PLR-LMR Scoring System For Lymph Node Metastasis In Patients With Gastric Cancer And The Role Of Assessing Prognosis

Objective To investigate the role of PLR-LMR scoring system in assessing the prognosis of gastric cancer patients.Methods The study population was 1075 gastric cancer patients admitted and surgically treated in the First Affiliated Hospital of Anhui Medical University during the 3 years from 2015 to 2017,and the medical records of all patients were collected.All patients were grouped according to the median of PLR.and LMR(130.6,4.5),and the diffrences in clinicopathological data between patients in diffrent groups were analyzed using chi-square analysis,and Cox regression models were constructed according to the prognostic status of patients to find the factors influencing the prognosis of gastric cancer patients.Kaplan-Meier survival curves were plotted and Log-Rank survival analysis was performed to construct the PLR-LMR.prognostic scoring system.The validity of the system was investigated according to the above steps,and finally the ROC curves of prognosis of gastric cancer patients were plotted to demonstrate the sensitivity and accuracy of the scoring system compared with PLR and LMR alone in assessing the prognosis of gastric cancer patients.Resnlts The chi-square test showed that high PLR was associated with preoperative Hb level,depth of tumor infiltration lymph node metastasis TNM stage,pathological type,and survival status of gastric cancer patients(P<0.05),while LMR was associated with patients’ gender,age,preoperative CEA level,CA19-9 level,Hb level,and survival status Multifaotorial analysis suggested that both high preoperative PLR.as well as low LMR were independent influencing factors for patient survival(P<0.05).Based on the results of survival analysis suggesting that there was no significant difference in survival of patients with different PLR and LMR(P>0.05),a scoring system for prognosis of gastric cancer patients was constructed according to this result.This scoring system was significantly associated with patients,CA19-9 level,Hb level,depth of tumor infiltration,lymph node metastas,TNM stage,pathological type and survival status(P<0.05).Survival analysis showed that the prognosis of patients with different scores were significantly different(P<0.05).The ROC curve for predicting the prognosis of patients with gastric cancer had an AUC of 0.662 for the PLR-LMR scoring system,which was higher than that of PLR(0.621)as well as LMR(0.614).Conclusion Preoperative PLR as well as LMR levels in gastric cancer patients have an impact on patient prognosis,and the PLR-LMR scoring system is more sensitive for predicting postoperative survival in gastric cancer patients compared with PLR or LMR alone.