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Value of Preoperative Hematological Parameters in the Prognosis of Gastric Cancer Patients Undergoing a Total Gastrectomy

Current Medical Science volume 42, pages 348–356 (2022)Cite this article

Abstract

Objective

This study aimed to evaluate the relationships between the albumin/globulin ratio (AGR), neutrophil/lymphocyte ratio (NLR), and platelet/lymphocyte ratio (PLR) and clinicopathological information for gastric cancer patients. In addition, the prognostic values of these hematological parameters for resectable gastric cancer patients undergoing a total gastrectomy were determined.

Methods

A total of 245 patients with gastric cancer who underwent a total gastrectomy at our hospital between January 1, 2005, and December 30, 2015, were enrolled into this study. The preoperative AGR, NLR, and PLR in the serum samples of the patients were measured. The relationships between the hematological parameters and the disease-free survival (DFS) as well as overall survival (OS) were analyzed by statistical analysis.

Results

The cutoff values of AGR, NLR, and PLR were 1.57, 3.5, and 193, respectively. Univariate analyses demonstrated that a low AGR, a high NLR, and a high PLR were significant risk factors for a poor prognosis. According to multivariate analysis, a high PLR was found to be independently associated with a poor survival. Additionally, when age was considered as a stratified factor, univariate analyses demonstrated that a low AGR had the tendency to be correlated with a shorter DFS in nonelderly patients (<65 years old). A low AGR was significantly correlated with a shorter DFS and OS in elderly patients (≥65 years old).

Conclusion

AGR, NLR, and PLR are independent risk factors associated with a poor gastric cancer survival by univariate analysis, and AGR is an independent risk factor for predicting DFS and OS in elderly patients (≥65 years old) with gastric cancer after total gastrectomy.

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References

  1. Song Z, Wu Y, Yang J, et al. Progress in the treatment of advanced gastric cancer. Tumour Biol, 2017,39(7):1010428317714626

    Article  Google Scholar 

  2. Yoo YJ, Kang CM, Choi M, et al. Preoperative prognostic nutritional index as an independent prognostic factor for resected ampulla of Vater cancer. PLoS One. 2020,15(3):e0229597

    Article  CAS  Google Scholar 

  3. Wu X, Jiang Y, Ge H, et al. Predictive value of prognostic nutritional index in patients with oral squamous cell carcinoma. Oral Dis, 2020,26(5):903–911

    Article  Google Scholar 

  4. Karsiyakali N, Karabay E, Yucetas U. Predictive value of prognostic nutritional index on tumor stage in patients with primary bladder cancer. Arch Esp Urol, 2020,73(2):132–139

    Google Scholar 

  5. Migita K, Takayama T, Saeki K, et al. The prognostic nutritional index predicts long-term outcomes of gastric cancer patients independent of tumor stage. Ann Surg Oncol, 2013,20(8):2647–2654

    Article  Google Scholar 

  6. Caputo F, Dadduzio V, Tovoli F, et al. The role of PNI to predict survival in advanced hepatocellular carcinoma treated with Sorafenib. PLoS One, 2020,15(5):e0232449

    Article  CAS  Google Scholar 

  7. Mori S, Usami N, Fukumoto K, et al. The Significance of the Prognostic Nutritional Index in Patients with Completely Resected Non-Small Cell Lung Cancer. PLoS One, 2015,10(9):e0136897

    Article  Google Scholar 

  8. Shi M, Zhao W, Zhou F, et al. Neutrophil or platelet-to-lymphocyte ratios in blood are associated with poor prognosis of pulmonary large cell neuroendocrine carcinoma. Transl Lung Cancer Res, 2020,9(1):45–54

    Article  CAS  Google Scholar 

  9. Schwartz PB, Poultsides G, Roggin K, et al. PLR and NLR Are Poor Predictors of Survival Outcomes in Sarcomas: A New Perspective From the USSC. J Surg Res, 2020,251:228–238

    Article  Google Scholar 

  10. Catal O, Ozer B, Sit M. Prediction of Lymph Node Metastasis in Colon Cancer via Platelet to Lymphocyte Ratio and Platelet Count. J Coll Physicians Surg Pak. 2020,30(3):250–253

    Article  Google Scholar 

  11. Fan W, Zhang Y, Wang Y, et al. Neutrophil-to-lymphocyte and platelet-to-lymphocyte ratios as predictors of survival and metastasis for recurrent hepatocellular carcinoma after transarterial chemoembolization. PLoS One, 2015,10(3):e119312

    Article  Google Scholar 

  12. Fnda FL, Barroso-Sousa R, Bento AS, et al. Pre-treatment neutrophil-to-lymphocyte ratio affects survival in patients with advanced hepatocellular carcinoma treated with sorafenib. Med Oncol, 2014,31(11):264

    Article  Google Scholar 

  13. Chu MO, Shen CH, Chang TS, et al. Pretreatment inflammation-based markers predict survival outcomes in patients with early stage hepatocellular carcinoma after radiofrequency ablation. Sci Rep, 2018,8(1):16611

    Article  Google Scholar 

  14. Tajiri K, Baba H, Kawai K, et al. Neutrophil-to-lymphocyte ratio predicts recurrence after radiofrequency ablation in hepatitis B virus infection. J Gastroenterol Hepatol. 2016;31(7):1291–1299.

    Article  CAS  Google Scholar 

  15. Liao W, Zhang J, Zhu Q, et al. Preoperative neutrophil-to-lymphocyte ratio as a new prognostic marker in hepatocellular carcinoma after curative resection. Transl Oncol, 2014,7(2):248–255

    Article  Google Scholar 

  16. Galizia G, Auricchio A, de Vita F, et al. Inflammatory and nutritional status is a predictor of long-term outcome in patients undergoing surgery for gastric cancer. Validation of the Naples prognostic score. Ann Ital Chir, 2019,90:404–416

    Google Scholar 

  17. Kosuga T, Konishi T, Kubota T, et al. Value of Prognostic Nutritional Index as a Predictor of Lymph Node Metastasis in Gastric Cancer. Anticancer Res, 2019,39(12):6843–6849

    Article  Google Scholar 

  18. Liu J, Chen S, Geng Q, et al. Prognostic value of pretreatment albumin-globulin ratio in predicting long-term mortality in gastric cancer patients who underwent D2 resection. Onco Targets Ther, 2017,10:2155–2162

    Article  CAS  Google Scholar 

  19. Zhang Y, Zhu JY, Zhou LN, et al. Predicting the Prognosis of Gastric Cancer by Albumin/Globulin Ratio and the Prognostic Nutritional Index. Nutr Cancer, 2020,72(4):635–644

    Article  CAS  Google Scholar 

  20. Mori K, Janisch F, Mostafaei H, et al. Prognostic value of preoperative blood-based biomarkers in upper tract urothelial carcinoma treated with nephroureterectomy: A systematic review and meta-analysis. Urol Oncol, 2020,38(5):315–333

    Article  CAS  Google Scholar 

  21. Xu K, Li J, Hu M, et al. Prognostic Significance of Preoperative Inflammatory Biomarkers and Traditional Clinical Parameters in Patients with Spinal Metastasis from Clear Cell Renal Cell Carcinoma: A Retrospective Study of 95 Patients in a Single Center. Cancer Manag Res, 2020,12:59–70

    Article  CAS  Google Scholar 

  22. Zeng L, Tian M, Chen SS. Short-term Outcomes of Laparoscopic vs. Open Hepatectomy for Primary Hepatocellular Carcinoma: A Prospective Comparative Study. Curr Med Sci, 2019,39(5):778–783

    Article  CAS  Google Scholar 

  23. Ammannagari N, Atasoy A. Current status of immunotherapy and immune biomarkers in gastroesophageal cancers. J Gastrointest Oncol, 2018,9:196–207

    Article  Google Scholar 

  24. Dolan RD1, McSorley ST2, Park JH2, et al. The prognostic value of systemic inflammation in patients undergoing surgery for colon cancer: comparison of composite ratios and cumulative scores. Br J Cancer, 2018,119(1):40–51

    Article  CAS  Google Scholar 

  25. Chen L, Wang X, Shu J, et al. Diagnostic value of serum D-dimer, CA125, and neutrophil-to-lymphocyte ratioin differentiating ovarian cancer and endometriosis. Int J Gynaecol Obstet, 2019,147(2):212–218

    Article  CAS  Google Scholar 

  26. Guo HW, Yuan TZ, Chen JX, et al. Prognostic value of pretreatment albumin/globulin ratio in digestive system cancers: A meta-analysis. PLoS One, 2018,13(1):e0189839

    Article  Google Scholar 

  27. Chen WZ, Yu ST, Xie R, et al. Preoperative albumin/globulin ratio has predictive value for patients with laryngeal squamous cell carcinoma. Oncotarget, 2017,8(29):48240–48247

    Article  Google Scholar 

  28. Koparal MY, Polat F, Çetin S, et al. Prognostic role of preoperative albumin to globulin ratio in predicting survival of clear cell renal cell carcinoma. Int Braz J Urol, 2018,44(5):933–946

    Article  Google Scholar 

  29. Du XJ, Tang LL, Mao YP, et al. The Pretreatment Albumin to Globulin Ratio Has Predictive Value for Long-Term Mortality in Nasopharyngeal Carcinoma. PLoS One, 2014,9(4):e94473

    Article  Google Scholar 

  30. Zeng X, Liu G, Pan Y, et al. Prognostic Value of Clinical Biochemistry-Based Indexes in Nasopharyngeal Carcinoma. Front Oncol, 2020,10:146

    Article  Google Scholar 

  31. Liu C, Wang W, Meng XY, et al. Albumin/globulin ratio is negatively correlated with PD-1 and CD25 mRNA levels in breast cancer patients. Onco Targets Ther, 2018,11:2131–2139

    Article  Google Scholar 

  32. Owusu-Agyemang P, Cata JP, Fournier KF, et al. Evaluating the impact of total intravenous anesthesia on the clinical outcomes and perioperative NLR and PLR profiles of patients undergoing cytoreductive surgery with hyperthermic intraperitoneal chemotherapy. Ann Surg Oncol, 2016,23:2419–2429

    Article  Google Scholar 

  33. Miyamoto R, Inagawa S, Sano N, et al. The neutrophil-to-lymphocyte ratio (NLR) predicts short-term and long-term outcomes in gastric cancer patients. Eur J Surg Oncol, 2018,44:607–612

    Article  Google Scholar 

  34. Chen LC, Li SH, Lo CM, et al. Platelet-to-lymphocyte ratio is an independent prognosticator in patients with esophageal squamous cell carcinoma receiving esophagectomy. J Thorac Dis, 2019,11(11):4583–4590

    Article  Google Scholar 

  35. Liu XZ, Wang JM, Ji YX, et al. Monocyte-to-high-density lipoprotein cholesterol ratio is associated with the presence and size of thyroid nodule irrespective of the gender. Lipids Health Dis, 2020,19(1):36

    Article  Google Scholar 

  36. Tohme S, Sukato D, Chalhoub D, et al. Neutrophil lymphocyte ratio is a simple and novel biomarker for prediction of survival after radioembolization for metastatic colorectal cancer. Ann Surg Oncol, 2015,22:1701–1707

    Article  Google Scholar 

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Acknowledgments

The authors thank Dr. Pan Jianhong for his help with the statistical analysis.

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Authors and Affiliations

  1. Oncology Department, Peking University First Hospital, Beijing, 100034, China

    Xi-shan Zhu, Fei-yan Ma & Shi-kai Wu

  2. Pathology Department, Peking University First Hospital, Beijing, 100034, China

    Ye Zhao

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  1. Xi-shan Zhu
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  2. Ye Zhao
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  4. Shi-kai Wu
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Corresponding author

Correspondence to Shi-kai Wu.

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The authors declare that they have no conflicts of interest.

Additional information

This study was supported by the Science Foundation of Peking University First Hospital.

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Zhu, Xs., Zhao, Y., Ma, Fy. et al. Value of Preoperative Hematological Parameters in the Prognosis of Gastric Cancer Patients Undergoing a Total Gastrectomy. CURR MED SCI 42, 348–356 (2022). https://doi.org/10.1007/s11596-022-2514-7

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  • DOI: https://doi.org/10.1007/s11596-022-2514-7

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