Affiliations: [a] Department of Oncology, First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China | [b] Department of Thoracic Surgery, The Affiliated Jiangning Hospital of Nanjing Medical University, Nanjing, Jiangsu, China
Correspondence:
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Corresponding authors: Wei Zhu and Ping Liu, Department of Oncology, First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China. Tel.: +86 139 1389 4911, +86 25 83718836 6080; Fax: +86 25 83780826; E-mail:zhuwei1983213@163.com,liu-ping@csco.org.cn
Note: [1] Contributed equally to this work.
Abstract: BACKGROUND: Recently, many studies have investigated the value of
the hematologic markers in the prognosis of gastric cancer (GC). However,
most studies only focused on the pre-operative markers. The aim of this
study was to investigate the prognostic value of the hematologic markers of
resectable GC patients at three different periods of the treatment
(preoperative, postoperative and before the first chemotherapy).
METHODS: Clinical data from 451 GC patients were retrospectively
collected. Hematologic markers including leukocyte, neutrophil, lymphocyte,
red blood cell (RBC), platelet, mean platelet volume (MPV), neutrophil
proportion (NP), lymphocyte proportion (LP), neutrophil lymphocyte ratio
(NLR), and platelet lymphocyte ratio (PLR) were adopted as potential
prognostic biomarkers. The Kaplan-Meier method and Cox regression model
were applied to reveal the prognostic significance of the hematologic
markers.
RESULTS: Preoperative PLR was independently associated with overall
survival (OS) via multivariate analysis (hazard ratio, 1.399; 95%
confidence interval, 1.015-1.928; p = 0.04). Elevated PLR predicted a larger
tumor size (P< 0.001), deeper tumor invasion (P= 0.035) and elevated level of
CEA (P= 0.012). CONCLUSIONS: Although only high preoperative PLR could serve as an
independent unfavorable prognostic factor, other markers such as
preoperative and postoperative NLR could also provide additionally
prognostic information.
