Prognostic value of lymphocyte-to-C-reactive protein ratio in patients with gastric cancer after surgery: a multicentre study

Abstract

Objective The immune inflammation-based score is recognized as a prognostic marker for cancer. However, the most accurate prognostic marker for patients with gastric cancer remains undetermined. We aimed to evaluate the predictive value of the lymphocyte-to-C-reactive protein ratio for outcomes in gastric cancer patients after radical gastrectomy. Methods A total of 607 gastric cancer patients treated at three Chinese institutions were included. Receiver operating characteristic curves were generated, and the areas under the curve were calculated to compare the predictive value among the inflammation-based score, lymphocyte-to-C-reactive protein ratio, C-reactive protein/albumin and neutrophil-lymphocyte, platelet-lymphocyte and lymphocyte-monocyte ratios. Cox regression was performed to determine the prognostic factors for overall survival. Results The median follow-up time was 63 months (range: 1–84 months). The optimal cut-off value for lymphocyte-to-C-reactive protein ratio was 0.63. The patients were divided into the LCR <0.63 (LLCR, n = 294) group and the LCR ≥0.63 (HLCR, n = 313) group. LLCR was significantly correlated with poor clinical characteristics. Compared with inflammation-based score, lymphocyte-to-C-reactive protein ratio had the highest areas under the curve (0.695). Patients with LLCR experienced more post-operative complications than the HLCR group (20.4 vs. 12.1%, P = 0.006). Multivariate analysis showed that a higher lymphocyte-to-C-reactive protein ratio (HR: 0.545, 95%CI: 0.372–0.799, P = 0.002) was associated with better overall survival. The HLCR group had higher 5-year overall survival rate than the LLCR group (80.5 vs. 54.9%, P < 0.001). Conclusions Preoperative lymphocyte-to-C-reactive protein ratio levels can effectively predict the short-term and oncological efficacy of gastric cancer patients after radical gastrectomy with a predictive value significantly better than other inflammation-based score.

Prognostic Significance of Preoperative Lymphocyte-to-C-Reactive Protein Ratio in Patients with Non-Metastatic Colorectal Cancer

“…29 Similarly, several researchers demonstrated that the LCR was the most reliable prognostic indicator as compared to other inflammatory indexes in patients with gastric cancer and renal cell cancer. 11,12 The present study also found that the operative LCR had the strongest discriminative ability in assessing the survival outcome of non-metastatic CRC and might complement the existing AJCC staging system to a certain degree.…”

“…9,10 Recently, another alternative composite inflammatory index, lymphocyte-to-C-reactive protein (LCR), represented as a combination of circulating lymphocyte and C-reactive protein counts, has been gained notable attention as a prognostic factor in gastric cancer, rectal cancer, and cholangiocarcinoma. [11][12][13] However, the prognostic potential of LCR has not been explored for patients with non-metastatic CRC. Moreover, it remains unclear which combination of inflammatory markers might be best in predicting survival outcome in patients with CRC.…”

<p>Prognostic Value of the Preoperative Lymphocyte-to-C-Reactive Protein Ratio and Albumin-to-Globulin Ratio in Patients with Osteosarcoma</p>

“…44 A recent multicenter study revealed that preoperative LCR could effectively predict the short-and long-term oncological outcome for gastric cancer (GC) patients undergoing radical gastrectomy. 41 Moreover, Okugawa et al 23 also demonstrated that the preoperative LCR was an independent prognostic factor for both the disease-free survival (DFS) and OS in GC patients. However, no relevant studies have reported the prognostic role of preoperative LCR in patients with osteosarcoma.…”

“…16,23,25,31,40 Recent studies have displayed that the preoperative LCR could reflect both the immunological response and systemic inflammation in cancer patients. 23,28,41 Serum CRP (C-reactive protein to albumin ratio), as a well-established inflammatory marker, has been demonstrated to exert an essential role in tumor development. The high preoperative CRP level was shown to be associated with a poor prognosis in cancer patients.…”

Parameters of Complete Blood Count Might Predict the Prognosis of Patients with Advanced Gastric Cancer

“…For example, with advances in the eld of immunotherapy, immune markers related to treatment response, such as tumor mutation burden, PD-L1 level, have been identi ed [6]. Besides, the relationship between more easily accessible acute phase reactants such as C-reactive protein, erythrocyte sedimentation rate and cancer prognosis has been studied many times [7][8][9]. In addition to these markers, the Neutrophil / lymphocyte ratio (NLR), which can be detected by complete blood count, is known as a good marker of host immunity and has shown its power to predict prognosis in many types of cancer [10][11][12][13].…”