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.
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.
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).
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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Song Z, Wu Y, Yang J, et al. Progress in the treatment of advanced gastric cancer. Tumour Biol, 2017,39(7):1010428317714626
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
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
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
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
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
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
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
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
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
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
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
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
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.
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
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
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
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
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
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
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
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
Ammannagari N, Atasoy A. Current status of immunotherapy and immune biomarkers in gastroesophageal cancers. J Gastrointest Oncol, 2018,9:196–207
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
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
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
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
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
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
Zeng X, Liu G, Pan Y, et al. Prognostic Value of Clinical Biochemistry-Based Indexes in Nasopharyngeal Carcinoma. Front Oncol, 2020,10:146
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
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
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
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
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
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
The authors thank Dr. Pan Jianhong for his help with the statistical analysis.
The authors declare that they have no conflicts of interest.
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