The value of platelet-to-lymphocyte ratio for evaluation of recurrence risk in patients with gastrointestinal stromal tumor

Abstract

Objective To investigate the relationship between platelet-to-lymphocyte ratio (PLR) and clinicopathological features and postoperative recurrence risk of gastrointestinal stromal tumors. Methods The clinicopathological data of 92 patients with gastrointestinal stromal tumors treated in the Gastrointestinal Surgery of Beijing Hospital from January 2006 to December 2011 were retrospectively analyzed. The PLR values were calculated and the receiver operating characteristic (ROC) curve and Youden index were used to determine the cut-off value of the PLR. The clinicopathological characteristics and postoperative recurrence risk between the two groups were analyzed. Subgroup analysis was performed on the basis of National Institutes of Health risk criteria according to preoperative and postoperative PLR cutoff values. Results The average preoperative and postoperative PLR of 92 patients were 148.4±70.5 and 206.7±115.3, respectively. When the preoperative and postoperative PLR value were 167.2 and 175.2 respectively, the Youden index were the largest, the sensitivities were 61.9% and 85.7%, respectively, and the specificities were 76.1% and 54.9%, respectively. Patients were divided into preoperative low PLR group (62/92, 67.4%) and preoperative high PLR group (30/92, 32.6%) based on the cut-off value of 167.2. Patients were divided into postoperative low PLR group (42/92, 45.7%) and postoperative high PLR group (50/92, 54.3%) based on the cut-off value of 175.2. The 1, 3, and 5-year recurrence-free survival rates in the preoperative high PLR group were 90.0%, 69.9% and 40.4% respectively. The 1, 3, and 5-year recurrence-free survival rates in the preoperative low PLR group were 96.8%, 89.9% and 75.6%, respectively, and the difference was statistically significant (χ2=7.461, P<0.05). The 1, 3, and 5-year recurrence-free survival rates in the postoperative high PLR group were 94.0%, 71.3% and 45.3%, respectively. The 1, 3, and 5-year recurrence-free survival rates in the preoperative low PLR group were 97.6%, 93.4% and 83.0%, respectively, and the difference was statistically significant (χ2=9.894, P<0.05). Multivariate analysis showed that the high risk of tumor classification and preoperative PLR≥167.2 were independent risk factors affecting the 5-year recurrence-free survival rates of GIST patients (all P values<0.05). Conclusions PLR can better reflect postoperative recurrence risk of gastrointestinal stromal tumors, and might be a valuable marker for recurrence risk assessment of gastrointestinal stromal tumors. Key words: Gastrointestinal stromal tumors; Platelet count; Lymphocyte count; Digestive System surgical procedures; Prognosis