内容紹介
Summary
Background: This study examined the significance of preoperative neutrophil-lymphocyte ratio(NLR)as a predictor of postoperative outcomes of gastric cancer(GC). Methods: NLR was calculated in 447 patients with GC undergoing curative gastrectomy, and its associations with postoperative short- and long-term outcomes were retrospectively examined. Results: Patients were divided into high-(n=313)or low-(n=134)NLR groups using an optimal cut-off NLR value of 1.6 according to the ROC curve analysis. A high-NLR was significantly associated with other clinical factors such as undifferentiated histology, advanced cT, and cN+. There was no difference in the incidence of postoperative complications between the 2 groups. Meanwhile, a high NLR was associated with a poor 5-year overall survival. Multivariate analysis identified preoperative NLR to be an independent prognostic factor(hazard ratio: 2.77, 95% confidence interval: 1.39-6.33, p=0.003)along with performance status, tumor location, and cT. Conclusion: Preoperative NLR could be one of the useful predictors of postoperative long-term outcomes of GC.
要旨
目的: 胃癌術後予後予測における術前好中球リンパ球比(NLR)の重要性について検討した。対象および方法: 2008年1月～2013年5月に胃癌に対する根治切除が行われた447例を対象とし,術前NLR値と術後短期・長期成績との関連を後方視的に検討した。結果: 術後5年全生存予測のROC曲線でAUC値が最も高値となるNLR値1.6をcut off値とし,NLR高値群(n=313)と低値群(n=134)に分類した。臨床因子との相関解析では,NLR高値群で未分化型腺癌,cT2以深,cN+症例を有意に多く認めた。短期成績について,2群のClavien-Dindo分類Ⅱ以上の合併症発生率に有意差を認めなかった。長期成績に関して,NLR高値群では術後5年全生存が有意に不良であり,多変量解析ではperformance status,腫瘍局在,cTとともに,術前NLRは独立予後規定因子であった(ハザード比: 2.77,95%信頼区間: 1.39-6.33,p=0.003)。結語: 胃癌手術症例において,術前NLR値は有用な予後予測因子となり得る。
目次
Background: This study examined the significance of preoperative neutrophil-lymphocyte ratio(NLR)as a predictor of postoperative outcomes of gastric cancer(GC). Methods: NLR was calculated in 447 patients with GC undergoing curative gastrectomy, and its associations with postoperative short- and long-term outcomes were retrospectively examined. Results: Patients were divided into high-(n=313)or low-(n=134)NLR groups using an optimal cut-off NLR value of 1.6 according to the ROC curve analysis. A high-NLR was significantly associated with other clinical factors such as undifferentiated histology, advanced cT, and cN+. There was no difference in the incidence of postoperative complications between the 2 groups. Meanwhile, a high NLR was associated with a poor 5-year overall survival. Multivariate analysis identified preoperative NLR to be an independent prognostic factor(hazard ratio: 2.77, 95% confidence interval: 1.39-6.33, p=0.003)along with performance status, tumor location, and cT. Conclusion: Preoperative NLR could be one of the useful predictors of postoperative long-term outcomes of GC.
要旨
目的: 胃癌術後予後予測における術前好中球リンパ球比(NLR)の重要性について検討した。対象および方法: 2008年1月～2013年5月に胃癌に対する根治切除が行われた447例を対象とし,術前NLR値と術後短期・長期成績との関連を後方視的に検討した。結果: 術後5年全生存予測のROC曲線でAUC値が最も高値となるNLR値1.6をcut off値とし,NLR高値群(n=313)と低値群(n=134)に分類した。臨床因子との相関解析では,NLR高値群で未分化型腺癌,cT2以深,cN+症例を有意に多く認めた。短期成績について,2群のClavien-Dindo分類Ⅱ以上の合併症発生率に有意差を認めなかった。長期成績に関して,NLR高値群では術後5年全生存が有意に不良であり,多変量解析ではperformance status,腫瘍局在,cTとともに,術前NLRは独立予後規定因子であった(ハザード比: 2.77,95%信頼区間: 1.39-6.33,p=0.003)。結語: 胃癌手術症例において,術前NLR値は有用な予後予測因子となり得る。