Application of platelet/lymphocyte and neutrophil/lymphocyte ratios in early diagnosis and prognostic prediction in patients with resectable gastric cancer

Article type: Research Article

Authors: Lian, Lian^{a; b} | Xia, You-You^{c; d} | Zhou, Chong^e | Shen, Xiao-Ming^b | Li, Xiang-Li^f | Han, Shu-Guang^f | Zheng, Yan^b | Mao, Zhong-Qi^g | Gong, Fei-Ran^h | Wu, Meng-Yao^a | Chen, Kai^a | Tao, Min^{a; i; j; k; *} | Li, Wei^{a; k; *}

Affiliations: [a] Department of Oncology, the First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China | [b] Department of Oncology, Suzhou Xiangcheng People's Hospital, Suzhou, Jiangsu, China | [c] Department of Radiation Oncology, Lianyungang First People's Hospital, Lianyungang, Jiangsu, China | [d] The Fourth Clinical Medical College, Nanjing Medical University, Nanjing, Jiangsu, China | [e] Department of Radiation Oncology, Xuzhou Central Hospital, Xuzhou, Jiangsu, China | [f] Department of General Surgery, Suzhou Xiangcheng People's Hospital, Suzhou, Jiangsu, China | [g] Department of Minimally Invasive Surgery, the First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China | [h] Department of Hematology, the First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China | [i] Jiangsu Institute of Clinical Immunology, Suzhou, Jiangsu, China | [j] Institute of Medical Biotechnology, Soochow University, Suzhou, Jiangsu, China | [k] PREMED Key Laboratory for Precision Medicine, Soochow University, Suzhou, Jiangsu, China

Correspondence: [*] Corresponding authors: Min Tao and Wei Li, Department of Oncology, the First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China. E-mail: [email protected], [email protected]; [email protected], [email protected]

Abstract: BACKGROUND: Gastric cancer is the fourth most frequent cancer and the second cause of cancer-related deaths worldwide. China has a high incidence of gastric cancer. Inflammation is a critical component of tumor progression. It has been widely accepted that gastric cancer is an inflammation-driven cancer. In this study, we investigated the application value of systemic inflammatory response (SIR) markers, platelet to lymphocyte ratio (PLR) and neutrophil to lymphocyte ratio (NLR), in early diagnosis and prognostic prediction in patients with resectable gastric cancer. MATERIALS AND METHODS: One hundred and sixty-two patients with resectable gastric cancer were included and separated into groups according to median pre-operative PLR or NLR values (PLR low: < 208 or PLR high: ≥ 208, and NLR low: < 4.02 or NLR high: ≥ 4.02, respectively). To evaluate the changes in PLR or NLR values after operation, we introduced the concept of postpre-operative PLR or NLR ratios (< 1 indicated PLR or NLR values were decreased after operation, while ≥ 1 suggested not decreased PLR or NLR values). RESULTS: Pre-operative PLR and NLR levels were significantly higher in gastric cancer patients compared with the healthy subjects. Low pre-operative PLR and NLR levels correlated with better clinicopathological features, including decreased depth of invasion, less lymph node metastasis and early tumor stage. Kaplan-Meier plots illustrated that higher pre-operative NLR and PLR had decreased overall survival (OS) and disease-free survival (DFS). Surgical tumor resection resulted in a significant CONCLUSIONS: PLR and NLR measurements can provide important diagnostic and prognostic results in patients with resectable gastric cancer.

Keywords: Gastric cancer, platelet to lymphocyte ratio (PLR), neutrophil to lymphocyte ratio (NLR)

DOI: 10.3233/CBM-150534

Journal: Cancer Biomarkers, vol. 15, no. 6, pp. 899-907, 2015