Significance of the preoperative neutrophil-to-lymphocyte ratio in the prognosis of patients with gastric cancer

AIM: To investigate the significance of the preoperative neutrophil-to-lymphocyte ratio(NLR) in the prognosis of patients with gastric cancer(GC). METHODS: The clinical data of 291 GC patients were analysed retrospectively; these patients were divided into two groups according to their preoperative NLR: a high-NLR group(NLR ≥ 3.5, 131 cases) and a low-NLR group(NLR < 3.5, 160 cases). The clinicopathological characteristics and five-year survival rates of the two groups were compared. The NLR and other clinicopathological factors were subjected to univariate and multivariate survival analysis to evaluate the effects of the NLR on the prognosis of GC patients. RESULTS: The lowest preoperative NLR among the 291 patients was 0.56, whereas the highest preoperative NLR was 74.5. The mean preoperative NLR was 5.99 ± 8.98. Age, tumour size, T staging, tumour-node-metastasis(TNM) staging and platelet count were significantly different between the highand low-NLR groups(P < 0.05). The five-year survival rate of the high-NLR group was 17.0%, which was significantly lower than that of the low-NLR group(43.6%; 17.0% vs 43.6%, P < 0.05). The univariate analysis results showed that the five-year survival rate was related to age, tumour size, T staging, N staging, TNM staging, carcinoembryonic antigen value and NLR(P < 0.05). Multivariate analysis results showed that the NLR was an independent risk factor that likely affected the five-year survival rate of GC patients(P = 0.003, HR = 0.626, 95%CI: 0.460-0.852). CONCLUSION: The preoperative NLR could be used as a prognostic factor for GC patients; in particular, a high NLR corresponded to poor prognosis of GC patients.

Is Neutrophil-to-Lymphocyte Ratio a Prediction Marker for Success of Immunotherapy? Preliminary Results

Background: Cancer immunotherapy treatments enhance the cancer treatment approach. The neutrophil-to-lymphocyteratio (NLR) has been associated with cancer prognosis, affecting progression, chemosensitivity, radiosensitivity and toxicity. Patients and Methods: Ten patients (nine males, one female), aged 68 ± 10 years, were included in this study. Six patients had squamous cell carcinoma of the lungs and two had adenocarcinoma of the lungs. One patient suffered from limb soft tissue sarcoma and one had renal cell carcinoma. All patients had metastatic disease and were pretreated with chemotherapy or biologic agents. The rationale of testing NLR was to compare it to the clinical response of the patients assessed by RECIST criteria using computerized tomography (CT) scans. Results: In regression analysis, older patients were found to respond better to immunotherapy treatment than younger patients. NLR was 4.26 ± 2.25 (p 0.01) in the older patients group and 2.84 ± 0.90 (p 0.01) in the younger patients group. No difference in response according to tumor type (p = 0.479) was observed. Conclusion: We provide preliminary evidence demonstrating that low NLR helps in understanding the value of the underlying immune system in expecting a good outcome to immune treatment. The NLR is a simple and available biomarker, easy to apply in clinical practice.