title: Platelet to lymphocyte ratio as a novel prognostic tool for gallbladder carcinoma.
abstract: OBJECTIVE
  To preliminarily investigate the prognostic significance of the platelet to lymphocyte ratio (PLR) in patients with gallbladder carcinoma (GBC).
  
  
  METHODS
  Clinical data of 316 surgical GBC patients were analyzed retrospectively, and preoperative serum platelet and lymphocyte counts were used to calculate the PLR. The optimal cut-off value of the PLR for detecting death was determined by the receiver operating characteristic (ROC) curve. The primary outcome was overall survival, which was estimated by the Kaplan-Meier method. The log-rank test was used to compare the differences in survival. Then, we conducted multivariate Cox analysis to assess the independent effect of the PLR on the survival of GBC patients.
  
  
  RESULTS
  For the PLR, the area under the ROC curve was 0.620 (95%CI: 0.542-0.698, P = 0.040) in detecting death. The cut-off value for the PLR was determined to be 117.7, with 73.6% sensitivity and 53.2% specificity. The PLR was found to be significantly positively correlated with CA125 serum level, tumor-node-metastasis (TNM) stage, and tumor differentiation. Univariate analysis identified carcinoembryonic antigen (CEA), CA125 and CA199 levels, PLR, TNM stage, and the degree of differentiation as significant prognostic factors for GBC when they were expressed as binary data. Multivariate analysis showed that CA125 > 35 U/mL, CA199 > 39 U/mL, PLR ≥ 117.7, and TNM stage IV were independently associated with poor survival in GBC. When expressed as a continuous variable, the PLR was still an independent predictor for survival, with a hazard ratio of 1.018 (95%CI: 1.001-1.037 per 10-unit increase, P = 0.043).
  
  
  CONCLUSIONS
  The PLR could be used as a simple, inexpensive, and valuable tool for predicting the prognosis of GBC patients.
authors.affiliation: Qing Pang, Ling-Qiang Zhang, Rui-Tao Wang, Jian-Bin Bi, Jing-Yao Zhang, Kai Qu, Su-Shun Liu, Si-Dong Song, Xin-Sen Xu, Zhi-Xin Wang, Chang Liu, Department of Hepatobiliary Surgery, the First Affiliated Hospital of Medical College, Xi'an Jiaotong University, Xi'an 710061, Shaanxi Province, China.
authors.forename: Qing
authors.initials: Q
authors.lastname: Pang
authors.affiliation: Qing Pang, Ling-Qiang Zhang, Rui-Tao Wang, Jian-Bin Bi, Jing-Yao Zhang, Kai Qu, Su-Shun Liu, Si-Dong Song, Xin-Sen Xu, Zhi-Xin Wang, Chang Liu, Department of Hepatobiliary Surgery, the First Affiliated Hospital of Medical College, Xi'an Jiaotong University, Xi'an 710061, Shaanxi Province, China.
authors.forename: Ling-Qiang
authors.initials: LQ
authors.lastname: Zhang
authors.affiliation: Qing Pang, Ling-Qiang Zhang, Rui-Tao Wang, Jian-Bin Bi, Jing-Yao Zhang, Kai Qu, Su-Shun Liu, Si-Dong Song, Xin-Sen Xu, Zhi-Xin Wang, Chang Liu, Department of Hepatobiliary Surgery, the First Affiliated Hospital of Medical College, Xi'an Jiaotong University, Xi'an 710061, Shaanxi Province, China.
authors.forename: Rui-Tao
authors.initials: RT
authors.lastname: Wang
authors.affiliation: Qing Pang, Ling-Qiang Zhang, Rui-Tao Wang, Jian-Bin Bi, Jing-Yao Zhang, Kai Qu, Su-Shun Liu, Si-Dong Song, Xin-Sen Xu, Zhi-Xin Wang, Chang Liu, Department of Hepatobiliary Surgery, the First Affiliated Hospital of Medical College, Xi'an Jiaotong University, Xi'an 710061, Shaanxi Province, China.
authors.forename: Jian-Bin
authors.initials: JB
authors.lastname: Bi
authors.affiliation: Qing Pang, Ling-Qiang Zhang, Rui-Tao Wang, Jian-Bin Bi, Jing-Yao Zhang, Kai Qu, Su-Shun Liu, Si-Dong Song, Xin-Sen Xu, Zhi-Xin Wang, Chang Liu, Department of Hepatobiliary Surgery, the First Affiliated Hospital of Medical College, Xi'an Jiaotong University, Xi'an 710061, Shaanxi Province, China.
authors.forename: Jing-Yao
authors.initials: JY
authors.lastname: Zhang
authors.affiliation: Qing Pang, Ling-Qiang Zhang, Rui-Tao Wang, Jian-Bin Bi, Jing-Yao Zhang, Kai Qu, Su-Shun Liu, Si-Dong Song, Xin-Sen Xu, Zhi-Xin Wang, Chang Liu, Department of Hepatobiliary Surgery, the First Affiliated Hospital of Medical College, Xi'an Jiaotong University, Xi'an 710061, Shaanxi Province, China.
authors.forename: Kai
authors.initials: K
authors.lastname: Qu
authors.affiliation: Qing Pang, Ling-Qiang Zhang, Rui-Tao Wang, Jian-Bin Bi, Jing-Yao Zhang, Kai Qu, Su-Shun Liu, Si-Dong Song, Xin-Sen Xu, Zhi-Xin Wang, Chang Liu, Department of Hepatobiliary Surgery, the First Affiliated Hospital of Medical College, Xi'an Jiaotong University, Xi'an 710061, Shaanxi Province, China.
authors.forename: Su-Shun
authors.initials: SS
authors.lastname: Liu
authors.affiliation: Qing Pang, Ling-Qiang Zhang, Rui-Tao Wang, Jian-Bin Bi, Jing-Yao Zhang, Kai Qu, Su-Shun Liu, Si-Dong Song, Xin-Sen Xu, Zhi-Xin Wang, Chang Liu, Department of Hepatobiliary Surgery, the First Affiliated Hospital of Medical College, Xi'an Jiaotong University, Xi'an 710061, Shaanxi Province, China.
authors.forename: Si-Dong
authors.initials: SD
authors.lastname: Song
authors.affiliation: Qing Pang, Ling-Qiang Zhang, Rui-Tao Wang, Jian-Bin Bi, Jing-Yao Zhang, Kai Qu, Su-Shun Liu, Si-Dong Song, Xin-Sen Xu, Zhi-Xin Wang, Chang Liu, Department of Hepatobiliary Surgery, the First Affiliated Hospital of Medical College, Xi'an Jiaotong University, Xi'an 710061, Shaanxi Province, China.
authors.forename: Xin-Sen
authors.initials: XS
authors.lastname: Xu
authors.affiliation: Qing Pang, Ling-Qiang Zhang, Rui-Tao Wang, Jian-Bin Bi, Jing-Yao Zhang, Kai Qu, Su-Shun Liu, Si-Dong Song, Xin-Sen Xu, Zhi-Xin Wang, Chang Liu, Department of Hepatobiliary Surgery, the First Affiliated Hospital of Medical College, Xi'an Jiaotong University, Xi'an 710061, Shaanxi Province, China.
authors.forename: Zhi-Xin
authors.initials: ZX
authors.lastname: Wang
authors.affiliation: Qing Pang, Ling-Qiang Zhang, Rui-Tao Wang, Jian-Bin Bi, Jing-Yao Zhang, Kai Qu, Su-Shun Liu, Si-Dong Song, Xin-Sen Xu, Zhi-Xin Wang, Chang Liu, Department of Hepatobiliary Surgery, the First Affiliated Hospital of Medical College, Xi'an Jiaotong University, Xi'an 710061, Shaanxi Province, China.
authors.forename: Chang
authors.initials: C
authors.lastname: Liu
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019540:Area Under Curve; D001792:Blood Platelets; D002277:Carcinoma / Q000097:blood* / Q000401:mortality / Q000473:pathology; D005260:Female; D005706:Gallbladder Neoplasms / Q000097:blood* / Q000401:mortality / Q000473:pathology; D006801:Humans; D053208:Kaplan-Meier Estimate; D018655:Lymphocyte Count; D008214:Lymphocytes; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009367:Neoplasm Staging; D010976:Platelet Count; D011237:Predictive Value of Tests; D016016:Proportional Hazards Models; D012372:ROC Curve; D012189:Retrospective Studies
keywords: Gallbladder carcinoma; Lymphocyte; Platelets; Prognosis; Survival