Pre-operative neutrophil-to-lymphocyte ratio is an independent prognostic factor in patients with gastric cancer

Han, Qiu‐Yue; Zhang, Xia; Zhang, Jiangang; Zhou, Wenjun; Chen, Qiong-Yuan; Chen, Yuanyuan; Yan, Wei‐Hua; Lin, Aifen

doi:10.1016/j.intimp.2022.109371

Cited by 9 publications

(7 citation statements)

References 57 publications

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“…In addition to genetic factors, the incidence of GC can also be attributed to various pathogenic infections, resulting in high morbidity and mortality (33,34). Despite the progress made in multimodal therapy for GC, recurrence of the disease is still common (35). Furthermore, owing to the absence of early diagnostic markers, GC is frequently diagnosed in its advanced stages, significantly diminishing the likelihood of survival, dependable biomarkers are critically necessary to facilitate early detection and survival forecasting.…”

Section: Discussionmentioning

confidence: 99%

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Prognostic value of neutrophil to lymphocyte ratio in gastric cancer patients receiving immune checkpoint inhibitors: a systematic review and meta-analysis

Zhang

Qiu

et al. 2023

Front. Oncol.

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BackgroundThe neutrophil to lymphocyte ratio (NLR) is a cost-effective and easily identifiable inflammatory biomarker that has been shown to be closely associated with tumor prognosis and predict survival in patients with multiple malignancies. However, the predictive value of NLR in patients with gastric cancer (GC) treated with immune checkpoint inhibitors (ICIs) has not been fully explored. Therefore, we conducted a meta-analysis to explore the potential of NLR as a predictor of survival in this population.MethodsWe systematically searched the PubMed, Cochrane Library, and EMBASE databases from inception to the present for observational researches on NLR and its relationship with progression or survival in GC patients receiving ICIs. To assess the prognostic significance of NLR on overall survival (OS) or progression-free survival (PFS), we used fixed or random-effect models to derive and combine hazard ratios (HRs) with 95% confidence intervals (CIs). We also examined the relationship between NLR and treatment efficacy by calculating relative risks (RRs) with 95% CIs for objective response rate (ORR) and disease control rate (DCR) in patients with GC receiving ICIs.ResultsNine studies of 806 patients were eligible. OS and PFS data were obtained from 9 and 5 studies, respectively. In nine studies, NLR was associated with poor survival, the pooled HR was 1.98 (95% CI 1.67- 2.35, p < 0.001), indicating a significant association between high NLR and worse OS. We conducted subgroup analyses based on study characteristics to confirm the robustness of our findings. A relationship between NLR and PFS were reported in five studies with a HR of 1.49 (95% CI 0.99- 2.23, p = 0.056), which was not significantly associated. Pooling four studies that examined the correlation between NLR and ORR/DCR in GC patients, we observed a significant correlation between NLR and ORR (RR = 0.51, p = 0.003), but no significant correlation between NLR and DCR (RR = 0.48, p = 0.111).ConclusionIn summary, this meta-analysis indicates that increased NLR is significantly linked to worse OS in patients with GC receiving ICIs. In addition, lowering NLR can improve ORR. Thus, NLR can serve as a predictor for prognosis and treatment response in GC patients treated with ICIs. Nevertheless, further high-quality prospective studies are required to verify our findings in the future.

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Section: Discussionmentioning

confidence: 99%

“…Han et al. demonstrated that pre-operative NLR is an independent prognostic factor in patients with GC and were associated with worse survival ( 38 ). Hirahara et al.…”

Section: Discussionmentioning

confidence: 99%

Prognostic value of neutrophil to lymphocyte ratio in gastric cancer patients receiving immune checkpoint inhibitors: a systematic review and meta-analysis

Zhang

Qiu

et al. 2023

Front. Oncol.

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“…Complete blood count-based biomarkers have been shown to correlate well with clinical outcomes in numerous chronic [ 5 , 6 , 7 , 8 , 9 , 10 ], infectious [ 11 , 12 , 13 , 14 , 15 ], and surgical conditions [ 16 , 17 , 18 , 19 , 20 ], as well as in cancer [ 21 , 22 , 23 , 24 , 25 , 26 ]. In particular, the potential role of the red cell distribution width (RDW), a biomarker of the heterogeneity of red blood cells’ size, in predicting adverse events and survival currently represents a topic of intense research in numerous clinical conditions [ 27 , 28 ], including malignancies such as colorectal cancer [ 29 , 30 , 31 ], esophageal cancer [ 32 , 33 ], lung cancer [ 34 , 35 ], breast cancer [ 36 , 37 ], and other malignancies [ 38 , 39 , 40 , 41 , 42 ].…”

Section: Introductionmentioning

confidence: 99%

Red Cell Distribution Width as a Predictor of Survival in Patients with Hepatocellular Carcinoma

Vidili,

Zinellu,

Mangoni

et al. 2024

Medicina

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Background and Objectives. Hepatocellular carcinoma (HCC) and the intrahepatic biliary tract cancers are estimated to rank sixth for incidence among solid cancers worldwide, and third for mortality rates. A critical issue remains the need for accurate biomarkers for risk stratification and overall prognosis. The aim of this study was to investigate the ability of a biomarker of heterogeneity of the size of red blood cells, the red cell distribution width (RDW), to predict survival in patients with HCC. Materials and Methods. A consecutive series of patients with a histologic diagnosis of HCC were included into this study irrespective of their age, stage of the disease, and treatment administered, and followed-up for a period of three years. Demographic, anthropometric [age, sex, body mass index (BMI)], and clinical data (Charlson Comorbidity Index, Child–Pugh score, etc.), along with laboratory tests were retrieved from clinical records. Results. One-hundred and four patients were included in this study. Among them, 54 (69%) were deceased at the end of the follow-up. Higher RDW values, but not other hematological and biochemical parameters, were significantly associated with mortality in both univariate and multivariate analysis. The optimal RDW cut-off value identified with the Youden test for survival was 14.7%, with 65% sensitivity and 74% specificity (AUC = 0.718, 95% CI 0.622–0.802, p < 0.001). Kaplan–Meier survival curves showed significantly lower survival with higher RDW values (HR = 3.5204; 95% CI 1.9680–6.2975, p < 0.0001) with a mean survival of 30.9 ± 9.67 months for patients with RDW ≤ 14.7% and 22.3 ± 11.4 months for patients with RDW > 14.7%. Conclusions. The results of our study showed that RDW can perform better than other blood-based biomarkers in independently predicting prognosis in patients with HCC.

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“…NLR is one of the systemic inflammation markers that correlate with clinical outcomes of various cancers, including gastric cancer, colorectal cancer, pancreatic cancer, and liver cancer 3–5 . The prognostic role of NLR in GC has been extensively reported by different groups 6–9 . However, the underlying mechanisms by which NLR in GC impacts prognosis remain uncertain.…”

Section: Introductionmentioning

confidence: 99%

T‐cells infiltration mediates the association between neutrophil/lymphocyte ratio and survival in gastric cancer

He,

Huangfu,

Fan

et al. 2023

Cancer Medicine

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BackgroundNeutrophil/lymphocyte ratio (NLR) is a vital index for systemic inflammation and a prognostic indicator for gastric cancer (GC). Despite the abundant literature on NLR's prognostic value for GC, the underlying factors mediating its impact on survival remain unclear. The objective of this study was to analyze the role of NLR in different prognostic models and subgroups, and investigate the mediating effects of immune infiltrates between NLR and survival.MethodsA total of 924 patients who underwent D2 lymph node resection were enrolled in this study. According to the level of NLR, patients were divided into two groups, the high and low NLR groups. Clinical parameters, indexes related to immune infiltrates, and survival were compared between the two groups. Prognostic models, interaction analysis, and mediating effects analysis were performed to investigate the clinical association of NLR, immune infiltrates, and survival.ResultsThe infiltration of CD3+ and CD8+ T cells was significantly different in the two NLR groups. The level of NLR was an independent prognostic predictor of GC. In addition, an interaction effect exists between NLR and MMR status on the prognosis of GC (p‐interaction <0.01). Lastly, the mediating effect analysis revealed that the infiltration level of CD3+ T cells was the mediating factor between NLR and survival (p < 0.001).ConclusionsThe level of NLR is an independent prognostic predictor of GC. The effect of NLR on prognosis is partly mediated by CD3+ T‐cell infiltration.

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Pre-operative neutrophil-to-lymphocyte ratio is an independent prognostic factor in patients with gastric cancer

Cited by 9 publications

References 57 publications

Prognostic value of neutrophil to lymphocyte ratio in gastric cancer patients receiving immune checkpoint inhibitors: a systematic review and meta-analysis

Prognostic value of neutrophil to lymphocyte ratio in gastric cancer patients receiving immune checkpoint inhibitors: a systematic review and meta-analysis

Red Cell Distribution Width as a Predictor of Survival in Patients with Hepatocellular Carcinoma

T‐cells infiltration mediates the association between neutrophil/lymphocyte ratio and survival in gastric cancer

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