Pretreatment predictive value of blood neutrophil/lymphocyte ratio in R0 gastric cancer resectability

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• 作者：Ana Borda ; ^{abordamartin@yahoo.es} ; Juan Vila ; Ignacio Ferná ; ndez-Urié ; n ; José ; Manuel Zozaya ; Ana Guerra ; Fernando Borda
• 关键词：Gastric cancer ; Resectability ; Neutrophil/lymphocyte ratio
• 刊名：Gastroenterología y Hepatología (English Edition)
• 出版年：2017
• 出版时间：January 2017
• 年：2017
• 卷：40
• 期：1
• 页码：1-9
• 全文大小：449 K
• 卷排序：40

文摘

New parameters complementary to clinical TNM classification are needed, to orient preoperative on the possibility of a R0 gastric cancer resection. We analysed the possible predictive value of blood neutrophil/lymphocytic ratio (N/L) in relation to resectability.MethodsTwo hundred and fifty-seven gastric cancers consecutively diagnosed and without neoadjuvant treatment were retrospectively studied. Univariate and multivariate analysis of the frequency of R0 cases was performed between groups with a normal N/L ratio (<5) and pathological N/L ratio (≥5). Furthermore, we studied the subgroup of operated patients (n = 156) analysing the frequency of R0 resection according to N/L ratio <5 or ≥5.ResultsOne hundred and fifty-six patients underwent surgical intervention, of which 139 had R0 resections. A high N/L ratio was registered in 46 cases (17.9%). Globally, resectability was higher in patients with a N/L ratio <5:59.7% vs. N/L ratio ≥5:28.6% (p < .001; OR = 3.76; 95% CI = 1.78–8.04). The relation between N/L ratio < 5 and R0 resection was confirmed in the multivariate (p = .006; OR = 3.86; 95% CI = 1.46–10.22). In the operated subgroup, the higher frequency of R0 resection achievement is maintained in cases with N/L ratio <5:91.3% vs. 72.2% (p = .015; OR = 4.04; 95% CI = 1.23–13.26).ConclusionsThe presence of a N/L ratio < 5 at the diagnosis of a gastric carcinoma is related in a significant and independent way with a higher frequency of R0 tumoral resection, globally. This higher proportion of R0 resection cases in patients with a N/L < 5 ratio is confirmed in the subgroup of operated patients.