The role of preoperative neutrophil–lymphocyte and platelet–lymphocyte ratio in patients after radical resection for gastric cancer

Jiang, Nan; Deng, Jing; Liu, Yong; Ke, Bin; Liu, Hong gen; Liang, Han

doi:10.3109/1354750x.2014.926567

Cited by 72 publications

(75 citation statements)

References 21 publications

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“…CRP is an index of systemic inflammation and has been identified as a prognostic factor in patients with CRC and gastric cancer (24,25). However, serum CRP levels are not routinely assessed in the pre-operative assessment (12,14,18). Instead, NLR and PLR, calculated from leukocyte differential counts and platelet counts, respectively, are more readily available and inexpensive compared to CRP (7).…”

Section: Discussionmentioning

confidence: 99%

“…Instead, NLR and PLR, calculated from leukocyte differential counts and platelet counts, respectively, are more readily available and inexpensive compared to CRP (7). Notably, numerous previous studies have already indicated that an elevated NLR and PLR is associated with a poorer survival in patients with ovarian (8), breast (9,10), non-small cell lung (11), esophageal (12,13), gastric (7,14) and hepatocellular cancers (15) and CRC (2,(16)(17)(18). NLR is the ratio of the absolute neutrophil count to the absolute lymphocyte count, and therefore the association between a high NLR and a poor prognosis, as revealed in the present study, is possibly indicative of the tumor-promoting activity associated with neutrophilia in the tumor environment.…”

Section: Discussionmentioning

confidence: 99%

“…Additionally, neutrophilia suppresses lymphocyte activity, therefore counteracting the antitumor immune response (7). An elevated NLR has been associated with a poor survival rate in breast (10), esophageal (12,13) and gastric cancers (7,14) and CRC (26). Chiang et al demonstrated that patients with an elevated NLR (>3) in colon cancer appeared to possess larger tumors and a more advanced tumor stage, and patients with stages I-III CRC possessed a poorer 5-year disease-free survival rate (26).…”

Section: Discussionmentioning

confidence: 99%

“…Notably, the scope and effects of an inflammatory reaction have always been assessed according to a number of biochemical markers, including the neutrophil lymphocyte ratio (NLR) and platelet lymphocyte ratio (PLR), which are inexpensive markers of systemic inflammation (7). Previous studies have indicated that elevated NLR or PLR suggested a poor prognosis for various types of cancer, including ovarian (8), breast (9,10), non-small cell lung (11), esophageal (12,13), gastric (7,14), hepatocellular (15) and CRC (2,(16)(17)(18). However, the current literature leaves certain questions unanswered.…”

Section: Introductionmentioning

confidence: 99%

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Clinical significance of pre-operative neutrophil lymphocyte ratio and platelet lymphocyte ratio as prognostic factors for patients with colorectal cancer

et al. 2016

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Abstract. The present study aimed to investigate the independent prognostic values of the pre-operative neutrophil lymphocyte ratio (NLR) and platelet lymphocyte ratio (PLR) in patients with colorectal cancer (CRC). The present study retrospectively analyzed the data of 216 patients with CRC from a single hospital. The clinicopathological characteristics of the patients were compared and prognostic factors were evaluated. NLR and PLR were associated with tumor differentiation status and the tumor diameter, respectively, and PLR was also associated with the primary tumor classification (T classification). Furthermore, NLR and PLR were positively associated with each other (R 2 =0.5368; P<0.0001). Univariate analyses indicated that stage II and III patients with a high NLR (≥4.98; P<0.001) or PLR (≥246.36; P<0.001) possessed a significantly poorer 5-year OS rate compared with those with a low NLR or PLR. Post-operative adjuvant chemotherapy improved the 5-year OS rate in patients with a high NLR or PLR. Multivariate analyses indicated that NLR and PLR were independent prognostic factors [NLR, relative risk (RR)=4.074 and P<0.001; PLR, RR=2.029 and P=0.029] in patients with CRC, and were associated with the T classification, lymph node metastasis and post-operative adjuvant chemotherapy response of patients. Additionally, the area under the curve (AUC) was 0.748 for NLR (95% CI, 0.684-0.804; P<0.0001) and 0.690 for PLR (95% CI, 0.623-0.751; P<0.0001). The RR and AUC indicated that NLR was the superior predictive factor in patients with CRC. In conclusion, the pre-operative NLR and PLR were significant independent prognostic factors in patients with CRC, and NLR was more effective as a prognostic marker compared with PLR. Adjuvant chemotherapy appeared to be more effective in CRC patients with a higher NLR or PLR.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Clinical significance of pre-operative neutrophil lymphocyte ratio and platelet lymphocyte ratio as prognostic factors for patients with colorectal cancer

et al. 2016

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“…Thus, in 377 patients who underwent curative resection for gastric cancer, high PLR was an independent predictive factor for worse overall survival [64]. In 162 patients diagnosed with resectable gastric cancer, high PLR correlated with decreased both overall and cancer-free survival [16].…”

Section: Plr and Survival: Prognostic Implicationsmentioning

confidence: 99%

Systemic Inflammatory Reaction in Gastric Cancer: Biology and Practical Implications of Neutrophil to Lymphocyte Ratio, Glasgow Prognostic Score and Related Parameters

Štrumfa¹,

Bogdanova²,

Kalva³

et al. 2017

Gastric Cancer

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Gastric cancer induces systemic inflammatory reaction (SIR) manifesting with changes in counts of white blood cell fractions and concentrations of acute phase proteins, clotting factors and albumins. Thus, protein-based scores or blood cell ratios (neutrophil to lymphocyte ratio (NLR); platelet to lymphocyte ratio (PLR)) are used to evaluate SIR. SIR tests are biologically justified by multiple clinically important and fascinating events including bone marrow activation, development of immune-suppressing immature myeloid cells, generation of pre-metastatic niches and neutrophil extracellular trap formation from externalised DNA network in bidirectional association with platelet activation. Despite biological complexity, clinical SIR assessment is widely available, patient-friendly and economically feasible. Here we present concise review on NLR, PLR, Glasgow prognostic score and fibrinogen -parameters that have prognostic role regarding overall, cancer-free and cancer-specific survival in early and advanced cases. Tumour burden can be predicted helping in preoperative detection of serosal or lymph node involvement. Practical consequences abound, including selection of surgical approach in respect to tumour burden, adjustments in treatment intensity by prognosis or evaluation of chemotherapy response. The chapter also scrutinises main controversies including different cut-off levels. Future developments should include elaboration of complex scores as described here. SIR parameters should be wisely incorporated in patients' treatment.

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An inflammatory biomarker‐based nomogram to predict prognosis of patients with nasopharyngeal carcinoma: an analysis of a prospective study

Chang

et al. 2016

Cancer Medicine

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Chronic inflammation plays an important role in tumor progression. The aim of this analysis was to evaluate whether inflammatory biomarkers such as the Glasgow prognostic score (GPS), the neutrophil‐lymphocyte ratio (NLR), the platelet‐lymphocyte ratio (PLR), and the lymphocyte‐monocyte ratio (LMR) could predict the prognosis of nasopharyngeal carcinoma (NPC). In this analysis, pretreatment GPS, NLR, PLR, LMR of 388 patients who were diagnosed as nonmetastatic NPC and recruited prospectively in the 863 Program No. 2006AA02Z4B4 were assessed. Of those, the 249 cases enrolled between December 27th 2006 and July 31st 2011 were defined as the development set. The rest 139 cases enrolled between August 1st 2011 and July 31st 2013 were defined as the validation set. The variables above were analyzed in the development set, together with age, gender, Karnofsky performance score, T stage, and N stage, with respect to their impact on the disease‐specific survival (DSS) through a univariate analysis. The candidate prognostic factors then underwent a multivariate analysis. A nomogram was established to predict the DSS, by involving the independent prognostic factors. Its predction capacity was evaluated through calculating Harrell's concordance index (C‐index) in the validation set. After multivariate analysis for the development set, age (≤50 vs. >50 years old), T stage (T1–2 vs. T3–4), N stage (N0–1 vs. N2–3) and pretreatment GPS (0 vs. 1–2), NLR (≤2.5 vs. >2.5), LMR (≤2.35 vs. >2.35) were independent prognostic factors of DSS (P values were 0.002, 0.008, <0.001, 0.004, 0.018, and 0.004, respectively). A nomogram was established by involving all the factors above. Its C‐index for predicting the DSS of the validation set was 0.734 (standard error 0.056). Pretreatment GPS, NLR, and LMR were independent prognostic factors of NPC. The nomogram based on them could be used to predict the DSS of NPC patients.

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The role of preoperative neutrophil–lymphocyte and platelet–lymphocyte ratio in patients after radical resection for gastric cancer

Cited by 72 publications

References 21 publications

Clinical significance of pre-operative neutrophil lymphocyte ratio and platelet lymphocyte ratio as prognostic factors for patients with colorectal cancer

Clinical significance of pre-operative neutrophil lymphocyte ratio and platelet lymphocyte ratio as prognostic factors for patients with colorectal cancer

Systemic Inflammatory Reaction in Gastric Cancer: Biology and Practical Implications of Neutrophil to Lymphocyte Ratio, Glasgow Prognostic Score and Related Parameters

An inflammatory biomarker‐based nomogram to predict prognosis of patients with nasopharyngeal carcinoma: an analysis of a prospective study

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