Prognostic Value of Neutrophil–Lymphocyte Ratio, Platelet–Lymphocyte Ratio, and Combined Neutrophil–Lymphocyte Ratio and Platelet–Lymphocyte Ratio in Stage IV Advanced Gastric Cancer
Huan Wang, Yongfeng Ding, Ning Li, Luntao Wu, Yuan Gao, Xiao Cheng, Haiping Jiang, Yulong Zheng, Chenyu Mao, Jing Deng, Haiyong Wang, Nong Xu
Abstract
Background: The prognostic value of neutrophil–lymphocyte ratio (NLR), platelet–¬-lymphocyte ratio, and the combined NLR-PLR score in patients with stage IV GC has not been clarified. Therefore, the main aim of this study was to explore the potential association of NLR, PLR, and NLR-PLR score and prognosis in patients with stage IV GC. Methods: This was a retrospective study of 466 GC patients diagnosed between 2010 and 2017. High NLR and high PLR were defined using the median values as the cut-off values. We then combined the NLR and PLR value and generated the NLR-PLR score as a new biomarker. Patients were separated into three parts according on the NLR-PLR score. Univariate and multivariate analyses were conducted to compare survival outcomes. Results: The median overall survival (OS) and progression-free survival (PFS) were 15.5 months (range, 0.7-96.8 months) and 6.7 months (range, 0.5-30.4 months). The NL, PLR and the NLR-PLR score were correlated with clinical outcomes including OS and PFS. The median OS for patients with NLR-PLR scores of 0, 1, and 2 were 22.5, 15.7, and 11.2 months, respectively. The median PFS for patients with NLR-PLR scores of 0, 1, and 2 were 7.8, 7.1 and 5.2 months, respectively (P<0.001). An high NLR-PLR score predicted poor survival time in patients with stage IV GC (all P<0.05). Conclusion: This analysis provides scientific evidence to support that NLR-PLR score may be a pre-treatment factor that independently predicts survival outcomes in GC patients.