Clinical significance of peripheral blood-derived inflammation markers in advanced gastric cancer after radical resectio
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RESEARCH ARTICLE
Open Access
Clinical significance of peripheral bloodderived inflammation markers in advanced gastric cancer after radical resection Lihu Gu1,2,3†, Mian Wang4†, Xuena Cui5, Jiahang Mo6, Lingling Yuan1, Feiyan Mao1, Kang Zhang7, Derry Minyao Ng7, Ping Chen1 and Dongjie Wang8*
Abstract Background: The prognostic significance of peripheral blood-derived inflammation markers in patients with gastric cancer (GC) has not been elucidated. This study aimed to investigate the relationship between systemic inflammatory markers and GC prognosis. Methods: A prospective observational cohort study involving 598 patients was conducted to analyze the prognosis of GC based on systemic inflammatory markers. The following peripheral blood-derived inflammation markers were evaluated: the neutrophil-lymphocyte ratio (NLR), platelet lymphocyte ratio (PLR), systemic immune-inflammation index (SII), C-reactive protein/albumin (CRP/Alb) ratio, Glasgow Prognostic Score (GPS), modified Glasgow Prognostic Score (mGPS), prognostic nutrition index (PNI), and prognostic index (PI). The receiver operating characteristics (ROC) curve and the Youden index were used to determine the optimal cutoff values. Univariate and multivariate analysis of prognostic factors was conducted accordingly. Results: The optimal cutoff values of the PNI, fibrinogen, NLR, PLR, SII, and CRP/Alb were 49.5, 397 ng/dl, 2.5, 154, 556, and 0.05, respectively. Multivariate analysis showed that age, PLR, TNM stage, and chemotherapy were the independent prognostic factors for advanced gastric cancer (AGC). Adjuvant chemotherapy improved the long-term prognosis of patients with PLR ≥154, but chemotherapy had no significant effect on the survival of patients with PLR < 154. Conclusions: Our findings show that higher PLR (≥154) is an independent risk factor for poor prognosis in GC patients. Besides, PLR can predict adjuvant chemotherapy (oxaliplatin/5-fluorouracil combination) response in patients with GC after surgery. Keywords: Gastric cancer, Systemic inflammatory marker, Platelet lymphocyte ratio, Prognosis, Chemotherapy
Background Gastric cancer (GC) is one of the most common malignant tumors and that poses a serious threat to human health, especially in Asia. Approximately 300,000 deaths and 400,000 new cases of GC occur in China every year * Correspondence: [email protected] † Lihu Gu and Mian Wang contributed equally to this work. 8 Department of Clinical Laboratory, HwaMei Hospital, University of Chinese Academy of Sciences, Northwest Street 41, Haishu District, Ningbo 315010, Zhejiang, China Full list of author information is available at the end of the article
[1]. Despite the advancement in diagnostic and treatment methods, the prognosis of advanced gastric cancer (AGC) patients has remained poor [2]. Tumor, Node, Metastasis (TNM) staging based on the International Union Against Cancer (UICC)/American Joint Committee on Cancer (AJCC) guidelines is currently the standard approach of determining the prognosis of GC patients [3]. However, several pro
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