Inflammation-based indexes and clinicopathologic features are strong predictive values of preoperative circulating tumor cell detection in gastric cancer patients.
OBJECTIVE
Circulating tumor cell (CTC) count and the host inflammatory response are two independent predictors for patients with various malignant disease. Several inflammation-based indicators have been demonstrated to have prognostic value in many malignant solid tumors, including systemic immune-inflammation index (SII), neutrophil lymphocyte ratio (NLR), platelet lymphocyte ratio (PLR), and prognostic nutrition index (PNI). The aim of this study was to evaluate the predictive value of the inflammation-based indexes including SII, NLR PLR, and PNI for CTC detection of gastric cancer patients before surgery.


METHODS
CTCs were measured using the isolation method by size of epithelial tumor cells and Wright staining for 60 patients with gastric cancer who underwent surgery. The indicators of SII, NLR, PLR, and PNI were calculated based on clinical laboratory testing.


RESULTS
The detected CTC number was correlated with extension of tumor invasion (p = 0.037), lymph node metastasis (p < 0.001), and TNM stage (p < 0.001). The CTC detection ratio was significantly correlated with T stage (p = 0.041), lymph node metastasis (p = 0.001), nerve fiber invasion of tumor outside the lymph nodes (p = 0.017), and TNM stage (p < 0.001). Statistical analysis showed that SII (p < 0.001), NLR (p < 0.001), PLR (p < 0.001), and PNI (p < 0.001) were significantly associated with positive CTC count and CTC detection rate.


CONCLUSIONS
This study provides evidence that preoperative indicators consisting of SII, NLR, PLR, and PNI are robust predictors for CTC detection in gastric cancer patients undergoing tumor resection.
Department of Oncology, Hubei Key of Laboratory of Tumor Biological Behaviors & Hubei Cancer Clinical Study Center, Zhongnan Hospital of Wuhan University, Wuhan, People's Republic of China.
L
L
Zheng
Department of Oncology, Hubei Key of Laboratory of Tumor Biological Behaviors & Hubei Cancer Clinical Study Center, Zhongnan Hospital of Wuhan University, Wuhan, People's Republic of China.
K
K
Zou
Department of Oncology, Hubei Key of Laboratory of Tumor Biological Behaviors & Hubei Cancer Clinical Study Center, Zhongnan Hospital of Wuhan University, Wuhan, People's Republic of China.
C
C
Yang
Department of Oncology, Hubei Key of Laboratory of Tumor Biological Behaviors & Hubei Cancer Clinical Study Center, Zhongnan Hospital of Wuhan University, Wuhan, People's Republic of China.
F
F
Chen
Department of Oncology, Hubei Key of Laboratory of Tumor Biological Behaviors & Hubei Cancer Clinical Study Center, Zhongnan Hospital of Wuhan University, Wuhan, People's Republic of China.
T
T
Guo
Department of Oncology, Hubei Key of Laboratory of Tumor Biological Behaviors & Hubei Cancer Clinical Study Center, Zhongnan Hospital of Wuhan University, Wuhan, People's Republic of China. binxiong1963@163.com.
B
B
Xiong
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor / Q000097:blood*; D005260:Female; D006801:Humans; D007249:Inflammation / Q000473:pathology*; D018655:Lymphocyte Count; D008297:Male; D008875:Middle Aged; D009360:Neoplastic Cells, Circulating / Q000473:pathology*; D009504:Neutrophils; D010976:Platelet Count; D011379:Prognosis; D013274:Stomach Neoplasms / Q000473:pathology*
D014408:Biomarkers, Tumor
Circulating tumor cell (CTC); Gastric cancer; Lymphocyte ratio (PLR); Neutrophil lymphocyte ratio (NLR); Prognostic nutrition index (PNI); Systemic immune-inflammation index (SII)