The evaluation of immune and nutrition-based prognostic index for gastric cancer

Abstract

Objective To assess the prognostic significance of prognostic nutritional index (PNI), neutrophil lymphocyte ratio (NLR) and platelet-lymphocyte ratio in gastric cancer patients. Methods Clinico-pathological data of 257 patients with gastric cancer in the First Affiliated Hospital of Anhui Medical University between January 2010 and January 2011 was analyzed retrospectively. The ROC curve and Youden index were used to determine the cut-off value, survival curves were described by Kaplan-Meier method and compared by Log-rank test. The univariate and multivariate analyses were performed with the Cox proportional hazard model to identify the prognostic factors. Results PNI was positively correlated with ages, tumor size, depth of tumor invasion, TNM stages, albumin, pre-albumin and hemoglobin (all P<0.05). NLR was associated with the tumor size, the depth of invasion, lymph node metastasis, TNM stages, albumin, pre-albumin and hemoglobin (all P<0.05). PLR was associated with the tumor size, pre-albumin and hemoglobin (all P<0.05). The Kaplan-Meier curves showed that gastric cancer patients had longer overall time in the low NLR group, low PLR group and high PNI group than in the high NLR group, high PLR group and low PNI group respectively (all P<0.05). The multivariate analyses showed that PNI and NLR were independent factors for predicting overall survival of gastric cancer patients. Conclusions PNI and NLR have more predictive value of overall survival than the PLR, PNI and NLR are independent prognostic factors of OS (overall survival) in gastric cancer. Key words: Stomed neoplasms; Nutritional assessment; Lymphocyte count; Platelet count