title: The Value of Preoperative Neutrophil to Lymphocyte Ratio in Indicating Lymph Node Metastasis in Patients with Resectable T2 Stage Gastric Adenocarcinoma.
abstract: BACKGROUND
  Lymph node metastasis (LNM) is closely associated with poor prognosis in patients with resectable T2 stage gastric adenocarcinoma (RT2-GA). Preoperative blood neutrophil to lymphocyte ratio (NLR) has been identified to be a very valuable predictor for prognosis in patients with diverse cancers. The aim of this investigation was to assess the relationship between NLR and LNM in RT2-GA.
  
  
  METHODS
  This retrospective study reviewed 230 patients who underwent surgery for removal of primary T2-GA from August 2002 to December 2013 in a single hospital. Preoperative routine blood test data were collected and the relationship between NLR and LNM in RT2-GA was evaluated by X2 test and multivariate logistic regression analysis.
  
  
  RESULTS
  The median value of NLR was 2.18 among 230 patients. Based on the median NLR value, the patients were categorized into two groups: low NLR group (NLR ≤ 2.18) and high NLR group (NLR > 2.18). χ2 test results exhibited that the preoperative NLR was significantly associated with the numbers of metastatic lymph nodes (≤ 6 and > 6) (p = 0.003) and status of lymph node involvement (N0, N1, and N2 stage) (p = 0.032). Multivariate analyses further confirmed that NLR > 2.18 was significantly associated with increased risk of appearing more numbers of metastatic lymph node or higher N stage which exhibited a 4.15- or 7.09-fold elevated risk compared to that of NLR ≤ 2.18.
  
  
  CONCLUSIONS
  The preoperative NLR is closely associated with LNM in patients with RT2-GA, which may be used as a predictor indicating more serious LNM in this type of cancer.
authors.forename: Dezhu
authors.initials: D
authors.lastname: Zheng
authors.forename: Youdong
authors.initials: Y
authors.lastname: Lin
authors.forename: Yinghao
authors.initials: Y
authors.lastname: Yu
authors.forename: Kai
authors.initials: K
authors.lastname: Wang
authors.forename: Xiaojuan
authors.initials: X
authors.lastname: Ouyang
authors.forename: Yuan
authors.initials: Y
authors.lastname: Dang
authors.forename: Qiaojia
authors.initials: Q
authors.lastname: Huang
mesh_terms: D000230:Adenocarcinoma / Q000276:immunology / Q000473:pathology*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008207:Lymphatic Metastasis; D008214:Lymphocytes; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D009504:Neutrophils; D013274:Stomach Neoplasms / Q000276:immunology / Q000473:pathology*