title: Significance of the preoperative neutrophil-to-lymphocyte ratio in the prognosis of patients with gastric cancer.
abstract: OBJECTIVE
  To investigate the significance of the preoperative neutrophil-to-lymphocyte ratio (NLR) in the prognosis of patients with gastric cancer (GC).
  
  
  METHODS
  The clinical data of 291 GC patients were analysed retrospectively; these patients were divided into two groups according to their preoperative NLR: a high-NLR group (NLR ≥ 3.5, 131 cases) and a low-NLR group (NLR < 3.5, 160 cases). The clinicopathological characteristics and five-year survival rates of the two groups were compared. The NLR and other clinicopathological factors were subjected to univariate and multivariate survival analysis to evaluate the effects of the NLR on the prognosis of GC patients.
  
  
  RESULTS
  The lowest preoperative NLR among the 291 patients was 0.56, whereas the highest preoperative NLR was 74.5. The mean preoperative NLR was 5.99 ± 8.98. Age, tumour size, T staging, tumour-node-metastasis (TNM) staging and platelet count were significantly different between the high- and low-NLR groups (P < 0.05). The five-year survival rate of the high-NLR group was 17.0%, which was significantly lower than that of the low-NLR group (43.6%; 17.0% vs 43.6%, P < 0.05). The univariate analysis results showed that the five-year survival rate was related to age, tumour size, T staging, N staging, TNM staging, carcinoembryonic antigen value and NLR (P < 0.05). Multivariate analysis results showed that the NLR was an independent risk factor that likely affected the five-year survival rate of GC patients (P = 0.003, HR = 0.626, 95%CI: 0.460-0.852).
  
  
  CONCLUSIONS
  The preoperative NLR could be used as a prognostic factor for GC patients; in particular, a high NLR corresponded to poor prognosis of GC patients.
authors.affiliation: Liang Yu, Cheng-Yu Lv, Ai-Hua Yuan, Wei Chen, An-Wei Wu, Department of General Surgery, Nanjing First Hospital, Nanjing Medical University, Nanjing 210006, Jiangsu Province, China.
authors.forename: Liang
authors.initials: L
authors.lastname: Yu
authors.affiliation: Liang Yu, Cheng-Yu Lv, Ai-Hua Yuan, Wei Chen, An-Wei Wu, Department of General Surgery, Nanjing First Hospital, Nanjing Medical University, Nanjing 210006, Jiangsu Province, China.
authors.forename: Cheng-Yu
authors.initials: CY
authors.lastname: Lv
authors.affiliation: Liang Yu, Cheng-Yu Lv, Ai-Hua Yuan, Wei Chen, An-Wei Wu, Department of General Surgery, Nanjing First Hospital, Nanjing Medical University, Nanjing 210006, Jiangsu Province, China.
authors.forename: Ai-Hua
authors.initials: AH
authors.lastname: Yuan
authors.affiliation: Liang Yu, Cheng-Yu Lv, Ai-Hua Yuan, Wei Chen, An-Wei Wu, Department of General Surgery, Nanjing First Hospital, Nanjing Medical University, Nanjing 210006, Jiangsu Province, China.
authors.forename: Wei
authors.initials: W
authors.lastname: Chen
authors.affiliation: Liang Yu, Cheng-Yu Lv, Ai-Hua Yuan, Wei Chen, An-Wei Wu, Department of General Surgery, Nanjing First Hospital, Nanjing Medical University, Nanjing 210006, Jiangsu Province, China.
authors.forename: An-Wei
authors.initials: AW
authors.lastname: Wu
mesh_terms: D000368:Aged; D016009:Chi-Square Distribution; D005260:Female; D005743:Gastrectomy; D006801:Humans; D053208:Kaplan-Meier Estimate; D016015:Logistic Models; D018655:Lymphocyte Count; D008214:Lymphocytes; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009367:Neoplasm Staging; D009504:Neutrophils; D011237:Predictive Value of Tests; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D012307:Risk Factors; D013274:Stomach Neoplasms / Q000097:blood* / Q000401:mortality / Q000473:pathology / Q000601:surgery; D013997:Time Factors; D016896:Treatment Outcome
keywords: Gastric cancer; Inflammation; Neutrophil-to-lymphocyte ratio; Prognosis; Survival rate