Clinical significance of neutrophil-to-lymphocyte ratio as a predictor of lymph node metastasis in gastric cancer
Posted on 2019-12-06 - 04:47
Abstract Background Precise staging is indispensable to select the appropriate treatment strategy for gastric cancer (GC); however, the diagnostic accuracy of conventional modalities needs to be improved. This study investigated the clinical significance of the preoperative neutrophil-to-lymphocyte ratio (NLR) for the prediction of pathological lymph node metastasis (pN+) in GC. Methods This was a retrospective study of 429 patients with GC who underwent curative gastrectomy. The predictive ability of NLR for pN+ was examined in comparison with that of computed tomography. Results The preoperative NLR ranged from 0.6 to 10.8 (median, 2.0), and the optimal cut-off value for predicting pN+ was 1.6 according to the receiver operating characteristic curve with the maximal Youden index. Multivariate analysis identified a NLR ≥ 1.6 (odds ratio (OR) 3.171; 95% confidence interval (CI) 1.448–7.235, p = 0.004) and cN+ (OR 2.426; 95% CI 1.221–4.958, p = 0.011) to be independent factors associated with pN+ in advanced GC (cT2-T4). On the other hand, a NLR ≥ 1.6 was not useful for predicting pN+ in early GC (cT1). In advanced GC, a NLR ≥ 1.6 detected pN+ with a higher sensitivity (84.9%) and negative predictive value (NPV) (63.9%) than conventional modalities (50.0 and 51.7%, respectively). When the subjects were limited to those with advanced GC with cN0, the sensitivity and NPV of a NLR ≥ 1.6 for pN+ increased further (90.7 and 81.0%, respectively). Conclusion The preoperative NLR may be a useful complementary diagnostic tool for predicting pN+ in advanced GC because of its higher sensitivity and NPV than conventional modalities.
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Kosuga, Toshiyuki; Konishi, Tomoki; Kubota, Takeshi; Shoda, Katsutoshi; Konishi, Hirotaka; Shiozaki, Atsushi; et al. (2019). Clinical significance of neutrophil-to-lymphocyte ratio as a predictor of lymph node metastasis in gastric cancer. figshare. Collection. https://doi.org/10.6084/m9.figshare.c.4772513.v1
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AUTHORS (16)
TK
Toshiyuki Kosuga
TK
Tomoki Konishi
TK
Takeshi Kubota
KS
Katsutoshi Shoda
HK
Hirotaka Konishi
AS
Atsushi Shiozaki
KO
Kazuma Okamoto
HF
Hitoshi Fujiwara
MK
Michihiro Kudou
TA
Tomohiro Arita
RM
Ryo Morimura
YM
Yasutoshi Murayama
YK
Yoshiaki Kuriu
HI
Hisashi Ikoma
MN
Masayoshi Nakanishi
EO
Eigo Otsuji