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Persistent elevation of postoperative neutrophil-to-lymphocyte ratio: A better predictor of survival in gastric cancer than elevated preoperative neutrophil-to-lymphocyte ratio

Title
Persistent elevation of postoperative neutrophil-to-lymphocyte ratio: A better predictor of survival in gastric cancer than elevated preoperative neutrophil-to-lymphocyte ratio
Author
민경환
Keywords
PROGNOSTIC-SIGNIFICANCE; TUMOR ANGIOGENESIS; CARCINOMA; INFLAMMATION
Issue Date
2017-10
Publisher
NATURE PUBLISHING GROUP
Citation
SCIENTIFIC REPORTS, v. 7, Article no. 13967
Abstract
Postoperative neutrophil-to-lymphocyte ratio change (NLRc) reflects the dynamic change of balance between host inflammatory response and immune response after treatment. In gastric cancer, an elevated initial NLR (iNLR) is reported to be a prognostic predictor, but the clinical application of the NLRc remains unclear. The NLRc was assessed in 734 patients undergoing total/subtotal gastrectomy and endoscopic submucosal dissection for gastric adenocarcinoma. The iNLR and NLRc were recorded within 10 days of the first diagnosis and 3-6 months after surgery, respectively. Using receiver operating characteristic (ROC) curves, we investigated the relationship between NLRc or iNLR and patient survival. The analysis revealed a higher predictive power for correlating patient survival with the NLRc compared with iNLR. NLRc was defined as negative (lower than iNLR) and positive (higher than iNLR). A positive NLRc was frequently observed in patients with advanced AJCC stage, local recurrence, distant metastasis, perineural invasion, and adjuvant chemotherapy (all p < 0.05). Univariate and multivariate analyses revealed a significant relationship between patient survival and NLRc (all p < 0.05) but no association between survival and iNLR. The NLRc could be a better indicator than iNLR for predicting survival in patients with gastric cancer.
URI
https://www.nature.com/articles/s41598-017-13969-xhttp://repository.hanyang.ac.kr/handle/20.500.11754/116032
ISSN
2045-2322
DOI
10.1038/s41598-017-13969-x
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COLLEGE OF MEDICINE[S](의과대학) > MEDICINE(의학과) > Articles
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