Combined neutrophil-lymphocyte ratio and platelet-lymphocyte ratio predicts chemotherapy response and prognosis in patients with advanced gastric cancer

Abstract

Background The neutrophil–lymphocyte ratio (NLR) and platelet–lymphocyte ratio (PLR) are representative blood markers of systemic inflammatory responses. However, the clinical significance of the combination of these markers is unclear. This study aimed to investigate the NLR and PLR in patients with advanced gastric cancer treated with chemotherapy and assess the clinical utility of a new blood score combining the NLR and PLR (NLR-PLR score) as a predictor of tumor response and prognosis. Methods We retrospectively analyzed 175 patients with gastric cancer receiving chemotherapy or chemoradiotherapy. These patients were categorized into progressive disease (PD) and non-PD groups according to tumor response. The NLR and PLR before treatment were examined, and the cut-off values were determined. The NLR-PLR score ranged from 0 to 2 as follows: score of 2, high NLR (> 2.461) and high PLR (> 248.4); score of 1, either high NLR or high PLR; score of 0, neither high NLR nor high PLR. Results With regard to tumor response, 64 and 111 patients had PD and non-PD, respectively. The NLR-PLR score was significantly higher in patients with PD than in those with non-PD ( p = 0.0009). The prognosis was significantly poorer in patients with a higher NLR-PLR score than in those with a lower NLR-PLR score ( p < 0.0001). Multivariate analysis demonstrated that the NLR-PLR score was an independent prognostic factor for prediction of overall survival ( p = 0.0392). Conclusion Low-cost stratification according to the NLR-PLR score might be a promising approach for predicting tumor response and prognosis in patients with advanced gastric cancer.

The derived neutrophil‐to‐lymphocyte ratio is an independent prognostic factor in patients with angioimmunoblastic T‐cell lymphoma

“…In recent years, studies have shown that the host immune system and tumour microenvironment play important roles in the pathogenesis and clinical outcomes of human malignant tumour (Capone et al , ). Therefore, it is worth noting that the combination of haematological components of the systemic inflammatory response, specifically derived neutrophil‐to‐lymphocyte ratio (dNLR), haemoglobin/platelet ratio (HPR) and platelet/lymphocyte ratio (PLR) have been shown to have prognostic value in patients with various solid tumours (Pichler et al , ; Hirahara et al , ). However, for AITL, these parameters have not been explored yet.…”

Development and validation of a novel nomogram to predict overall survival in gastric cancer with lymph node metastasis

“…The abnormal counts and ratio of neutrophil, lymphocyte, monocytes in the peripheral blood of cancer patients may be associated with tumor development [21]. Platelet lymphocyte ratio (PLR) has been reported as an independent risk factor in gastric cancer [6,22]. And it is reported that the coagulation pathway is essential for the establishment of metastasis in experimental model systems [23,24].…”

Clinical significance of peripheral blood-derived inflammation markers in advanced gastric cancer after radical resection

“…A study suggested that the sensitivity of chemotherapy (oxaliplatin/5-uorouracil combination) might be closely related to NLR, PLR, and their changes in metastatic gastric cancer [47]. Hirahara believed that the combination of NLR and PLR might be more effective in predicting the chemotherapy response in patients with metastatic gastric cancer [48]. Besides, Tang [49] and Chen [50] concluded that PLR could predict the e cacy of neoadjuvant chemotherapy of GC patients treated with oxaliplatin and capecitabine regimens.…”