Prognostic Value of Neutrophil-Lymphocyte Ratio, Platelet-Lymphocyte Ratio and Systemic Immune-Inflammatory Index in Resected Gastric Cancer

Hayriye Şahinli 1 * , Sema Türker 1
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1 Department of Medical Oncology, Ankara Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey
* Corresponding Author
J CLIN MED KAZ, Volume 4, Issue 54, pp. 34-39. https://doi.org/10.23950/1812-2892-JCMK-00724
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ABSTRACT

Objective: The prognostic value of neutrophil-lymphocyte ratio, platelet-lymphocyte ratio and systemic immune-inflammatory index has been studied in many cancer types. Our aim is to show the prognostic value of neutrophil-lymphocyte ratio, platelet-lymphocyte ratio and systemic immune-inflammatory index in resected gastric cancer patients. In addition, to determine which parameter is a better predictor of survival.
Material and methods: The study included 95 patients resected gastric cancer between 2014-2018. Receiver operating curve analysis was used to determine neutrophil-lymphocyte ratio, platelet-lymphocyte ratio and systemic immune-inflammatory index cut-off values. Systemic immune-inflammatory index was evaluated as neutrophil × platelet/lymphocyte. Long rank and cox regression analysis were used.
Results: The median age was 62 (22-84) years. The median overall survival was 33 months. 49 (51.6%) patients were in stage 3 and 46 (48.4 %) patients were in stage 1-2. High neutrophil-lymphocyte ratio, platelet-lymphocyte ratio and systemic immune-inflammatory index values, tumor depth, stage of metastatic lymph node and tumor-node-metastasis stage were poor prognostic factors for overall survival and disease-free survival. When multivariant cox regression analysis was performed, only platelet-lymphocyte ratio was found to be independent prognostic factor (p = 0.037 for overall survival, p = 0.024 for overall survival).
Conclusion: High neutrophil-lymphocyte ratio, platelet-lymphocyte ratio and systemic immune-inflammatory index were found to be poor prognostic factors in predicting both overall survival and disease-free survival before treatment in patients who undergo curative resection for gastric cancer. As a result of multivariant analysis, only high platelet-lymphocyte ratio was determined as an independent poor prognostic factor for both overall survival and disease-free survival.

CITATION

Şahinli H, Türker S. Prognostic Value of Neutrophil-Lymphocyte Ratio, Platelet-Lymphocyte Ratio and Systemic Immune-Inflammatory Index in Resected Gastric Cancer. Journal of Clinical Medicine of Kazakhstan. 2019;4(54):34-9. https://doi.org/10.23950/1812-2892-JCMK-00724

REFERENCES

  • Ferlay J, Soerjomataram I, Dikshit R, Eser S, Mathers C, Rebelo M, et al. Cancer incidence and mortality worldwide: sources, methods and major patterns in GLOBOCAN 2012. Int J Cancer. 2015;136(5):E359-86. https://doi.org/10.1002/ijc.29210
  • Torre LA, Bray F, Siegel RL, Ferlay J, Lortet-Tieulent J, Jemal A. Global cancer statistics, 2012. CA Cancer J Clin. 2015; 65(2):87-108. https://doi.org/10.3322/caac.21262
  • Powell A, Parkinson D, Patel N, Chan D, Christian A, Lewis WG. Prognostic Significance of Serum Inflammatory Markers in Gastric Cancer. J Gastrointest Surg. 2018; 22(4):595-605. https://doi.org/10.1007/s11605-017-3597-5
  • Zhang Y, Lu JJ, Du YP, Feng CX, Wang LQ, Chen MB. Prognostic value of neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio in gastric cancer. Medicine (Baltimore). 2018;97(12):e0144. https://doi.org/10.1097/MD.0000000000010144
  • Mellor KL, Powell A, Lewis WG. Systematic Review and Meta-Analysis of the Prognostic Significance of Neutrophil-Lymphocyte Ratio (NLR) After R0 Gastrectomy for Cancer. J Gastrointest Cancer. 2018; 49(3):237-44. https://doi.org/10.1007/s12029-018-0127-y
  • Zhu YL, Yang L, Sui ZQ, Liu L, Du JF. Clinicopathological features and prognosis of Borrmann type IV gastric cancer. J BUON. 2016; 21(6):1471-5.
  • Shah MA, Ajani JA. Gastric cancer--an enigmatic and heterogeneous disease. JAMA. 2010; 303(17):1753-4. https://doi.org/10.1001/jama.2010.553
  • Zhang X, Zhang W, Feng LJ. Prognostic significance of neutrophil lymphocyte ratio in patients with gastric cancer: a meta-analysis. PLoS One. 2014;9(11):e111906. https://doi.org/10.1371/journal.pone.0111906
  • Coussens LM, Werb Z. Inflammation and cancer. Nature. 2002; 420(6917):860-7. https://doi.org/10.1038/nature01322
  • Pardoll DM. Spinning molecular immunology into successful immunotherapy. Nat Rev Immunol. 2002;2(4):227-38. https://doi.org/10.1038/nri774
  • Homey B, Muller A, Zlotnik A. Chemokines: agents for the immunotherapy of cancer? Nat Rev Immunol. 2002; 2(3):175-84. https://doi.org/10.1038/nri748
  • Amedei A, Munari F, Bella CD, Niccolai E, Benagiano M, Bencini L, et al. Helicobacter pylori secreted peptidyl prolyl cis, trans-isomerase drives Th17 inflammation in gastric adenocarcinoma. Intern Emerg Med. 2014;9(3):303-9. https://doi.org/10.1007/s11739-012-0867-9
  • Kubota T, Hiki N, Nunobe S, Kumagai K, Aikou S, Watanabe R, et al. Significance of the inflammation-based Glasgow prognostic score for short- and long-term outcomes after curative resection of gastric cancer. J Gastrointest Surg. 2012;16(11):2037-44. https://doi.org/10.1007/s11605-012-2036-x
  • Hanahan D, Weinberg RA. Hallmarks of cancer: the next generation. Cell. 2011;144(5):646-74. https://doi.org/10.1016/j.cell.2011.02.013
  • Todoric J, Antonucci L, Karin M. Targeting Inflammation in Cancer Prevention and Therapy. Cancer Prev Res (Phila). 2016; 9(12):895-905. https://doi.org/10.1158/1940-6207.CAPR-16-0209
  • Shoda K, Komatsu S, Ichikawa D, Kosuga T, Okamoto K, Arita T, et al. Thrombocytosis Associated with Poor Prognosis in Patients with Gastric Cancer. Gan To Kagaku Ryoho. 2015; 42(12):1980-2.
  • Chen Y, Zhang L, Liu WX, Liu XY. Prognostic significance of preoperative anemia, leukocytosis and thrombocytosis in chinese women with epithelial ovarian cancer. Asian Pac J Cancer Prev. 2015;16(3):933-9. https://doi.org/10.7314/APJCP.2015.16.3.933
  • Dunn GP, Old LJ, Schreiber RD. The immunobiology of cancer immunosurveillance and immunoediting. Immunity. 2004; 21(2):137-48. https://doi.org/10.1016/j.immuni.2004.07.017
  • Dupre A, Malik HZ. Inflammation and cancer: What a surgical oncologist should know. Eur J Surg Oncol. 2018; 44(5):566-70. https://doi.org/10.1016/j.ejso.2018.02.209https://doi.org/10.1016/j.ejso.2018.02.209
  • Digklia A, Voutsadakis IA. Thrombocytosis as a prognostic marker in stage III and IV serous ovarian cancer. ObstetGynecol Sci. 2014;57(6):457-63. https://doi.org/10.5468/ogs.2014.57.6.457
  • Voutsadakis IA. Thrombocytosis as a prognostic marker in gastrointestinal cancers. World J Gastrointest Oncol. 2014; 6(2):34-40. https://doi.org/10.4251/wjgo.v6.i2.34
  • Cao W, Yao X, Cen D, Zhi Y, Zhu N, Xu L. Prognostic role of pretreatment thrombocytosis on survival in patients with cervical cancer: a systematic review and meta-analysis. World J Surg Oncol. 2019; 17(1):132. https://doi.org/10.1186/s12957-019-1676-7
  • Hirahara T, Arigami T, Yanagita S, Matsushita D, Uchikado Y, Kita Y, et al. Combined neutrophil-lymphocyte ratio and platelet-lymphocyte ratio predicts chemotherapy response and prognosis in patients with advanced gastric cancer. BMC Cancer. 2019;19(1):672. https://doi.org/10.1186/s12885-019-5903-y
  • Riedl J, Pabinger I, Ay C. Platelets in cancer and thrombosis. Hamostaseologie. 2014; 34(1):54-62. https://doi.org/10.5482/HAMO-13-10-0054
  • Sasaki K, Kawai K, Tsuno NH, Sunami E, Kitayama J. Impact of preoperative thrombocytosis on the survival of patients with primary colorectal cancer. World J Surg. 2012; 36(1):192-200. https://doi.org/10.1007/s00268-011-1329-7
  • Guo T, Krzystanek M, Szallasi Z, Szallasi A. Thrombocytosis portends adverse prognostic significance in patients with stage II colorectal carcinoma. F1000Res. 2014; 3:180. https://doi.org/10.12688/f1000research.4856.1
  • Graziosi L, Marino E, De Angelis V, Rebonato A, Cavazzoni E, Donini A. Prognostic value of preoperative neutrophils to lymphocytes ratio in patients resected for gastric cancer. Am J Surg. 2015; 209(2):333-7. https://doi.org/10.1016/j.amjsurg.2014.06.014
  • Sun X, Liu X, Liu J, Chen S, Xu D, Li W, et al. Preoperative neutrophil-to-lymphocyte ratio plus platelet-to-lymphocyte ratio in predicting survival for patients with stage I-II gastric cancer. Chin J Cancer. 2016;35(1):57. https://doi.org/10.1186/s40880-016-0122-2
  • Zhong JH, Huang DH, Chen ZY. Prognostic role of systemic immune-inflammation index in solid tumors: a systematic review and metaanalysis. Oncotarget. 2017;8(43):75381-8. https://doi.org/10.18632/oncotarget.18856