Abstract
Background: The indications for endoscopic submucosal dissection (ESD) for gastric cancer are based on preoperative histological assessment; however, examination of tissue biopsy is not always reliable as only a limited portion of the lesion can be obtained. The neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) are markers of inflammatory response and are potentially associated with the grade of malignancy in gastric cancer. We aimed to investigate the association between NLR and PLR and the histology of gastric cancer. Methods: This study included 218 patients who underwent ESD for gastric cancer. The relationship between NLR/PLR and histological diagnosis was investigated. Results: Patients with adenocarcinomas showed significantly higher NLR and PLR than those with adenomas (p < 0.001 and p < 0.05, respectively). Further, patients with undifferentiated adenocarcinoma showed a significantly higher NLR (p < 0.05) than those with differentiated adenocarcinoma. Conclusion: This study suggests that NLR could be a useful marker for assessing early gastric cancer.
Highlights
We found that neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) were significantly higher in patients with adenocarcinoma
This study suggests that NLR could be a useful marker for estimating the histological type of early gastric cancer prior to Endoscopic submucosal dissection (ESD)
We propose that the cut-off value of NLR above 3.0 suggests the histological type of early gastric cancer as undifferentiated-type or undifferentiated-type components mixed with differentiated-type
Summary
Publisher’s Note: MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affiliations. Gastric cancer is one of the most common gastrointestinal cancers and the third leading cause of cancer-related deaths worldwide [1]. A variety of treatment strategies are available for patients with early gastric cancer. Endoscopic submucosal dissection (ESD) is widely accepted and used as a treatment option for early gastric cancer. ESD is superior to conventional endoscopic mucosal resection in terms of removal of larger or ulcerated lesions in an en bloc manner and is more effective in preventing residual lesions and local recurrence
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