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Prognostic value of combined preoperative inflammatory marker neutrophil–lymphocyte ratio and platelet distribution width in patients with gallbladder carcinoma

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Abstract

Background

The neutrophil–lymphocyte ratio (NLR) and platelet distribution width (PDW) are associated with poor prognosis in various cancers. We aimed to analyze the prognostic value of the combination of preoperative NLR and PDW in patients with gallbladder carcinoma (GBC).

Methods

A total of 287 GBC patients who underwent curative-intent surgery in our institution was included. The relationship between NLR and PDW and clinicopathological features were analyzed. The receiver operating characteristic (ROC) curves were used to determine the optimal cutoff value for NLR and PDW. Overall survival (OS) was estimated using the Kaplan–Meier method. Meanwhile, the univariate and multivariate Cox regression models were used to assess the risk factors for OS.

Results

The optimal cutoff value of NLR and PDW was 3.00 and 14.76, respectively. In addition, survival analysis demonstrated that patients with NLR > 3.00 and PDW > 14.76 had a worse prognosis than patients with NLR ≤ 3.00 and PDW ≤ 14.76, respectively. The multivariate analysis showed that NLR and PDW were independent prognostic factors in the patients with GBC. When we combined NLR and PDW, the area under the ROC curve increased from 0.665 (NLR) and 0.632 (PDW) to 0.676. Moreover, the 1-, 3-, and 5-year OS of group A (patients with NLR ≤ 3.00 and PDW ≤ 14.76), group B (patients with either of NLR > 3.00 or PDW > 14.76) and group C (patients with NLR > 3.00 and PDW > 14.76) were 88.7%, 62.6%, 28.1%, 65.1%, 26.9%, 13.1%, and 34.8%, 8.3%, 0%, respectively.

Conclusion

The combination of NLR and PDW may serve as a significant prognostic biomarker for GBC patients superior to either NLR or PDW alone.

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Data availability

The data that support the findings of this study are available from the corresponding author upon reasonable request. All data generated and analyzed during the current study are included in this article and available from the corresponding author on reasonable request.

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Funding

This work was supported by1.3.5 project for disciplines of excellence, West China Hospital, Sichuan University (ZYJC21046); 1.3.5 project for disciplines of excellence-Clinical Research Incubation Project, West China Hospital, Sichuan University (2021HXFH001);Sichuan University-Zigong School-local Cooperation project (2021CDZG-23); Sichuan University-Sui Lin School-local Cooperation project (2022CDSN-18); Science and Technology project of the Health planning committee of Sichuan (21PJ046)；National Natural Science Foundation of China for Young Scientists Fund (82303669)；China Telecom Sichuan Company Biliary tract Tumor Big Data Platform and Application Phase I R&D Project(312230752).

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Author notes

  1. Fei Liu and Jun-Ke Wang are contributed equally to this work.

Authors and Affiliations

  1. Division of Biliary Tract Surgery, Department of General Surgery, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan Province, China

    Fei Liu, Jun-Ke Wang, Wen-Jie Ma, Hai-Jie Hu, Yan-Wen Jin & Fu-Yu Li

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  1. Fei Liu
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Contributions

Fei Liu and Jun-Ke Wang contributed to the data acquisition and drafted the manuscript. Wen-Jie Ma and Hai-Jie Hu contributed to data acquisition. Fu-Yu Li and Yan-Wen Jin contributed to the study design and revised the manuscript. Manuscript is approved by all authors for publication.

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Correspondence to Yan-Wen Jin or Fu-Yu Li.

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The authors declare no competing interests.

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This study conforms to the criteria of the Helsinki Declaration and current ethical guideline, and was approved by the Institutional Ethical Board of West China Hospital of Sichuan University (20231394).

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Liu, F., Wang, JK., Ma, WJ. et al. Prognostic value of combined preoperative inflammatory marker neutrophil–lymphocyte ratio and platelet distribution width in patients with gallbladder carcinoma. Langenbecks Arch Surg 409, 51 (2024). https://doi.org/10.1007/s00423-024-03247-6

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