Abstract
PurposeEvaluate the predictive value of the preoperative blood neutrophil-to-lymphocyte ratio (NLR) on the clinical outcomes of patients with gastric neuroendocrine neoplasms (g-NENs) after radical surgery.ResultsThe NLR was significantly higher in patients with g-NENs than in matched normal volunteers (P < 0.05). A higher blood NLR was not significantly associated with clinical characteristics (all P > 0.05). According to the multivariate analysis, the NLR was an independent prognostic factor of RFS and OS. Nomograms, including the NLR, Ki-67 index and lymph node ratio, had superior discriminative abilities to predict clinical outcomes. The recurrence rate was 37% (55/147). The median time to recurrence was 9 months; 48 (87%) patients experienced recurrence within the first 2 years. Both the NLR and Ki-67 index were correlated with liver metastases (both P < 0.05) and were also negatively correlated with recurrence time (both P < 0.05).Materials And MethodsWe enrolled 147 patients who were diagnosed with g-NENs and underwent radical surgery. Receiver operating characteristic curve analysis was used to identify the optimal value for blood NLR. Univariate and multivariate survival analysis were used to identify prognostic factors for g-NENs. A nomogram was adopted to predict RFS and OS after surgery.ConclusionsAs an independent prognostic factor for g-NENs, blood NLR can improve the predictability of RFS and OS. We recommend that g-NEN patients with a high blood NLR or high Ki-67 index undergo surveillance during the first month and then every 3 months for 2 years post-surgery.
Highlights
Gastric neuroendocrine neoplasms (g-NENs) are a type of relatively rare tumors mainly derived from enterochromaffin-like cells (ECL-cells) localized in the gastric mucosa [1]
As an independent prognostic factor for g-NENs, blood neutrophil-to-lymphocyte ratio (NLR) can improve the predictability of RFS and OS
We recommend that g-NEN patients with a high blood NLR or high Ki-67 index undergo surveillance during the first month and every 3 months for 2 years post-surgery
Summary
Gastric neuroendocrine neoplasms (g-NENs) are a type of relatively rare tumors mainly derived from enterochromaffin-like cells (ECL-cells) localized in the gastric mucosa [1]. Cancer Network (NCCN) guidelines [4, 5], the TNM scoring system includes the depth of invasion and lymph node metastases as very important prognostic factors for patients with g-NENs. The guidelines recommend that patients with g-NENs should be reevaluated 3 to 12 months after resection and every 6 to 12 months for up to 10 years. Little research has focused on the relationship between blood NLR and the prognosis of patients with neuroendocrine neoplasms, g-NENs. We evaluated blood NLR as a prognostic indicator and investigated its clinical value for postoperative surveillance in patients undergoing radical surgery for g-NENs
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