nach oben

Surgery Today

Erschienen in:

01.11.2014 | Original Article

Usefulness of the neutrophil/lymphocyte ratio measured preoperatively as a predictor of peritoneal metastasis in patients with advanced gastric cancer

verfasst von: Yusuke Nakayama, Naoto Gotohda, Hidehito Shibasaki, Shogo Nomura, Takahiro Kinoshita, Ryuichi Hayashi

Erschienen in: Surgery Today | Ausgabe 11/2014

Einloggen, um Zugang zu erhalten

Abstract

Purpose

The prognosis for gastric cancer patients with peritoneal metastasis is poor. Many studies have reported that the neutrophil/lymphocyte ratio (NLR) might be useful to predict the degree of progression of gastric cancer. In this study, we attempted to evaluate whether the NLR and other related laboratory parameters might be reliable predictors of the presence of peritoneal metastasis in patients with advanced gastric cancer.

Methods

The data of 359 patients who underwent gastric surgery between June 2008 and December 2011 were reviewed. A retrospective analysis of the preoperative blood data in relation to the presence of peritoneal metastasis was carried out.

Results

An increased serum C-reactive protein level (P = 0.022), APTT (P = 0.017) and NLR (P < 0.001), and a decreased serum Alb (P = 0.014) were significantly related to the presence of peritoneal metastasis. A multivariate analysis showed that a NLR >2.37 (OR = 2.59, 95 % CI = 1.38–4.93, P = 0.003) and clinical T4 stage (OR = 4.36, 95 % CI = 2.33–8.24, P < 0.001) were independent predictors of the presence of peritoneal metastasis.

Conclusion

Our results suggest that the preoperative NLR was a significant independent predictor of the presence of peritoneal metastasis in patients with advanced gastric cancer.

Jemal A, Bray F, Center MM, Ferlay J, Ward E, Forman D. Global cancer statistics. CA Cancer J Clin. 2011;61:69–90.PubMedCrossRef

Glockzin G, Piso P. Current status and future directions in gastric cancer with peritoneal dissemination. Surg Oncol Clin N Am. 2012;21:625–33.PubMedCrossRef

Ikeguchi M, Oka A, Tsujitani S, Maeta M, Kaibara N. Relationship between area of serosal invasion and intraperitoneal free cancer cells in patients with gastric cancer. Anticancer Res. 1994;14:2131–4.PubMed

Shimada H, Takiguchi N, Kainuma O, Soda H, Ikeda A, Cho A, et al. High preoperative neutrophil-lymphocyte ratio predicts poor survival in patients with gastric cancer. Gastric Cancer. 2010;13:170–6.PubMedCrossRef

Dutta S, Crumley AB, Fullarton GM, Horgan PG, McMillan DC. Comparison of the prognostic value of tumour and patient related factors in patients undergoing potentially curative resection of gastric cancer. Am J Surg. 2012;204:294–9.PubMedCrossRef

Chang CC, Sun CF, Pai HJ, Wang WK, Hsieh CC, Kuo LM, et al. Preoparative Serum C-reactive protein and gastric cancer; clinical-pathological correlation and prognostic significance. Chang Gung Med J. 2010;33:301–12.PubMed

Jung MR, Park YK, Jeong O, Seon JW, Ryu SY, Kim DY, et al. Elevated preoperative neutrophil to lymphocyte ratio predicts poor survival following resection in late stage gastric cancer. J Surg Oncol. 2011;104:504–10.PubMedCrossRef

Nozoe T, Iguchi T, Egashira A, Adachi E, Matsukuma A, Ezaki T. Significance of modified Glasgow prognostic score as a useful indicator for prognosis of patients with gastric carcinoma. Am J Surg. 2011;201:186–91.PubMedCrossRef

Nozoe T, Mori E, Takahashi I, Ezaki T. Preoperative elevation of serum C-reactive protein as an independent prognostic indicator of colorectal carcinoma. Surg Today. 2008;38:597–602.PubMedCrossRef

10.

Halazun KJ, Aldoori A, Malik HZ, Al-Mukhtar A, Prasad KR, Toogood GJ, et al. Elevated preoperative neutrophil to lymphocyte ratio predicts survival following hepatic resection for colorectal liver metastases. Eur J Surg Oncol. 2008;34:55–60.PubMedCrossRef

11.

Walsh SR, Cook EJ, Goulder F, Justin TA, Keeling NJ. Neutrophil-lymphocyte ratio as a prognostic factor in colorectal cancer. J Surg Oncol. 2005;91:181–4.PubMedCrossRef

12.

Aliustaoglu M, Bilici A, Ustaalioglu BB, Konya V, Gucun M, Seker M, Gumus M. The effect of peripheral blood values on prognosis of patients with locally advanced gastric cancer before treatment. Med Oncol. 2010;27:1060–5.PubMedCrossRef

13.

Yamanaka T, Matsumoto S, Teramukai S, Ishiwata R, Nagai Y, Fukushima M. The baseline ratio of neutrophils to lymphocytes is associated with patient prognosis in advanced gastric cancer. Oncology. 2007;73:215–20.PubMedCrossRef

14.

Forrest LM, McMillan DC, McArdle CS, Angerson WJ, Dunlop DJ. Evaluation of cumulative prognostic scores based on the systemic inflammatory response in patients with inoperable non-small-cell lung cancer. Br J Cancer. 2003;89:1028–30.PubMedCrossRefPubMedCentral

15.

Mohri Y, Tanaka K, Ohi M, Yokoe T, Miki C, Kusunoki M. Prognostic significance of host- and tumor-related factors in patients with gastric cancer. World J Surg. 2010;34:285–90.PubMedCrossRef

16.

Crumley AB, Stuart RC, McKernan M, Going JJ, Shearer CJ, McMillan DC. Comparison of pre-treatment clinical prognostic factors in patients with gastro-oesophageal cancer and proposal of a new staging system. J Gastrointest Surg. 2010;14:781–7.PubMedCrossRef

17.

Tomita M, Shimizu T, Ayabe T, Onitsuka T. Persistently high neutrophil to lymphocyte ratio after surgery indicate poor prognosis in non-small cell lung cancer patients. Ann Cancer Res Ther. 2011;19:54–6.CrossRef

18.

Balkwill F, Mantovani A. Inflammation and cancer: back to Virchow? Lancet. 2001;357:539–45.PubMedCrossRef

19.

Aizawa M, Gotohda N, Takahashi S, Konishi M, Kinoshita T. Predictive value of baseline neutrophil/lymphocyte ratio for T4 disease in wall-penetrating gastric cancer. World J Surg. 2011;35:2717–22.PubMedCrossRef

20.

Coussens LM, Werb Z. Inflammation and cancer. Nature. 2002;420:860–7.PubMedCrossRefPubMedCentral

21.

Yamashita H, Katai H. Systemic inflammatory response in gastric cancer. World J Surg. 2010;34:2399–400.PubMedCrossRef

22.

Zahorec R. Ratio of neutrophil to lymphocyte counts—rapid and simple parameter of systemic inflammation and stress in critically ill. Bratisl Lek Listy. 2001;102:5–14.PubMed

23.

Kusumanto YH, Dam WA, Hospers GA, Meijer C, Mulder NH. Platelets and granulocytes, in particular the neutrophils, form important compartments for circulating vascular endothelial growth factor. Angiogenesis. 2003;6:283–7.PubMedCrossRef

24.

Shamamian P, Schwartz JD, Pocock BJ, Monea S, Whiting D, Marcus SG, et al. Activation of progelatinase A (MMP-2) by neutrophil elastase, cathepsin G, and proteinase-3: a role for inflammatory cells in tumor invasion and angiogenesis. J Cell Physiol. 2001;189:197–206.PubMedCrossRef

25.

Fondevila C, Metges JP, Fuster J, Grau JJ, Palacin A, Castells A, et al. p53 and VEGF expression are independent predictors of tumour recurrence and survival following curative resection of gastric cancer. Br J Cancer. 2004;90:206–15.PubMedCrossRefPubMedCentral

26.

Petrie HT, Klassen LW, Kay HD. Inhibition of human cytotoxic T lymphocyte activity in vitro by autologous peripheral blood granulocytes. J Immunol. 1985;134:230–4.PubMed

27.

el-Hag A, Clark RA. Immunosuppression by activated human neutrophils. Dependence on the myeloperoxidase system. J Immunol. 1987;139:2406–13.PubMed

28.

Okano K, Maeba T, Moroguchi A, Ishimura K, Karasawa Y, Izuishi K, et al. Lymphocytic infiltration surrounding liver metastases from colorectal cancer. J Surg Oncol. 2003;82:28–33.PubMedCrossRef

29.

Lien YC, Hsieh CC, Wu YC, Hsu HS, Hsu WH, Wang LS, et al. Preoperative serum albumin level is a prognostic indicator for adenocarcinoma of the gastric cardia. J Gastrointest Surg. 2004;8:1041–8.PubMedCrossRef

30.

Onate-Ocana LF, Aiello-Crocifoglio V, Gallardo-Rincon D, Herrera-Goepfert R, Brom-Valladares R, Carrillo JF, et al. Serum albumin as a significant prognostic factor for patients with gastric carcinoma. Ann Surg Oncol. 2007;14:381–9.PubMedCrossRef

31.

Al-Shaiba R, McMillan DC, Angerson WJ, Leen E, McArdle CS, Horgan P. The relationship between hypoalbuminaemia, tumour volume and the systemic inflammatory response in patients with colorectal liver metastases. Br J Cancer. 2004;91:205–7.PubMedPubMedCentral

32.

Roxburgh CS, Salmond JM, Horgan PG, Oien KA, McMillan DC. Comparison of the prognostic value of inflammation-based pathologic and biochemical criteria in patients undergoing potentially curative resection for colorectal cancer. Ann Surg. 2009;249:788–93.PubMedCrossRef

33.

Yamagata Y, Amikura K, Kawashima Y, Yatsuoka T, Nishimura Y, Sakamoto H, et al. Staging laparoscopy in advanced gastric cancer: usefulness and issues requiring improvement. Hepatogastroenterology 2013;60:751–5.PubMed

34.

Kinoshita J, Fushida S, Harada S, Makino I, Nakamura K, Oyama K, et al. Type IV collagen levels are elevated in the serum of patients with peritoneal dissemination of gastric cancer. Oncol Lett. 2010;1:989–94.PubMedCrossRefPubMedCentral

35.

Emoto S, Ishigami H, Yamashita H, Yamaguchi H, Kaisaki S, Kitayama J. Clinical significance of CA125 and CA72-4 in gastric cancer with peritoneal dissemination. Gastric Cancer. 2012;15:154–61.PubMedCrossRef

Titel: Usefulness of the neutrophil/lymphocyte ratio measured preoperatively as a predictor of peritoneal metastasis in patients with advanced gastric cancer
verfasst von: Yusuke Nakayama
Naoto Gotohda
Hidehito Shibasaki
Shogo Nomura
Takahiro Kinoshita
Ryuichi Hayashi
Publikationsdatum: 01.11.2014
Verlag: Springer Japan
Erschienen in: Surgery Today / Ausgabe 11/2014
Print ISSN: 0941-1291
Elektronische ISSN: 1436-2813
DOI: https://doi.org/10.1007/s00595-014-0917-1

Leitlinien kompakt für die Allgemeinmedizin

Mit medbee Pocketcards sicher entscheiden.

^{Seit 2022 gehört die medbee GmbH zum Springer Medizin Verlag}

Kostenlos registrieren

Facharzt-Training Allgemeinmedizin

Die ideale Vorbereitung zur anstehenden Prüfung mit den ersten 24 von 100 klinischen Fallbeispielen verschiedener Themenfelder

Mehr erfahren

Neu im Fachgebiet Allgemeinmedizin

Akuter Schwindel: Wann lohnt sich eine MRT?

28.04.2024 Schwindel Nachrichten

Akuter Schwindel stellt oft eine diagnostische Herausforderung dar. Wie nützlich dabei eine MRT ist, hat eine Studie aus Finnland untersucht. Immerhin einer von sechs Patienten wurde mit akutem ischämischem Schlaganfall diagnostiziert.

Niedriger diastolischer Blutdruck erhöht Risiko für schwere kardiovaskuläre Komplikationen

25.04.2024 Hypotonie Nachrichten

Wenn unter einer medikamentösen Hochdrucktherapie der diastolische Blutdruck in den Keller geht, steigt das Risiko für schwere kardiovaskuläre Ereignisse: Darauf deutet eine Sekundäranalyse der SPRINT-Studie hin.

Therapiestart mit Blutdrucksenkern erhöht Frakturrisiko

25.04.2024 Hypertonie Nachrichten

Beginnen ältere Männer im Pflegeheim eine Antihypertensiva-Therapie, dann ist die Frakturrate in den folgenden 30 Tagen mehr als verdoppelt. Besonders häufig stürzen Demenzkranke und Männer, die erstmals Blutdrucksenker nehmen. Dafür spricht eine Analyse unter US-Veteranen.

Metformin rückt in den Hintergrund

24.04.2024 DGIM 2024 Kongressbericht

Es hat sich über Jahrzehnte klinisch bewährt. Doch wo harte Endpunkte zählen, ist Metformin als alleinige Erstlinientherapie nicht mehr zeitgemäß.

Update Allgemeinmedizin

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen

Springer Medizin

Abstract

Purpose

Methods

Results

Conclusion

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

Weitere Artikel der Ausgabe 11/2014

Aortoenteric fistula at the site of esophagojejunostomy after laparoscopic total gastrectomy: report of a case

Safety of fondaparinux to prevent venous thromboembolism in Japanese patients undergoing colorectal cancer surgery: a multicenter study

Re-sentinel node biopsy after previous breast and axillary surgery

The short- and long-term outcomes for patients with splenic flexure tumours treated by left versus extended right colectomy are comparable: a retrospective analysis

Oncoplastic surgery combining partial mastectomy and immediate volume replacement using a thoracodorsal adipofascial cutaneous flap with a crescent-shaped dermis

Three-dimensional computed tomography analysis of variations in the middle hepatic vein tributaries: proposed new classification