Clinical significance of neutrophil-to-lymphocyte ratio as a predictor of lymph node metastasis in gastric cancer
Abstract Background Precise staging is indispensable to select the appropriate treatment strategy for gastric cancer (GC); however, the diagnostic accuracy of conventional modalities needs to be improved. This study investigated the clinical significance of the preoperative neutrophil-to-lymphocyte...
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| Format: | Article |
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BMC
2019-12-01
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| Series: | BMC Cancer |
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| Online Access: | https://doi.org/10.1186/s12885-019-6404-8 |
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| author | Toshiyuki Kosuga Tomoki Konishi Takeshi Kubota Katsutoshi Shoda Hirotaka Konishi Atsushi Shiozaki Kazuma Okamoto Hitoshi Fujiwara Michihiro Kudou Tomohiro Arita Ryo Morimura Yasutoshi Murayama Yoshiaki Kuriu Hisashi Ikoma Masayoshi Nakanishi Eigo Otsuji |
| author_facet | Toshiyuki Kosuga Tomoki Konishi Takeshi Kubota Katsutoshi Shoda Hirotaka Konishi Atsushi Shiozaki Kazuma Okamoto Hitoshi Fujiwara Michihiro Kudou Tomohiro Arita Ryo Morimura Yasutoshi Murayama Yoshiaki Kuriu Hisashi Ikoma Masayoshi Nakanishi Eigo Otsuji |
| author_sort | Toshiyuki Kosuga |
| collection | DOAJ |
| description | Abstract Background Precise staging is indispensable to select the appropriate treatment strategy for gastric cancer (GC); however, the diagnostic accuracy of conventional modalities needs to be improved. This study investigated the clinical significance of the preoperative neutrophil-to-lymphocyte ratio (NLR) for the prediction of pathological lymph node metastasis (pN+) in GC. Methods This was a retrospective study of 429 patients with GC who underwent curative gastrectomy. The predictive ability of NLR for pN+ was examined in comparison with that of computed tomography. Results The preoperative NLR ranged from 0.6 to 10.8 (median, 2.0), and the optimal cut-off value for predicting pN+ was 1.6 according to the receiver operating characteristic curve with the maximal Youden index. Multivariate analysis identified a NLR ≥ 1.6 (odds ratio (OR) 3.171; 95% confidence interval (CI) 1.448–7.235, p = 0.004) and cN+ (OR 2.426; 95% CI 1.221–4.958, p = 0.011) to be independent factors associated with pN+ in advanced GC (cT2-T4). On the other hand, a NLR ≥ 1.6 was not useful for predicting pN+ in early GC (cT1). In advanced GC, a NLR ≥ 1.6 detected pN+ with a higher sensitivity (84.9%) and negative predictive value (NPV) (63.9%) than conventional modalities (50.0 and 51.7%, respectively). When the subjects were limited to those with advanced GC with cN0, the sensitivity and NPV of a NLR ≥ 1.6 for pN+ increased further (90.7 and 81.0%, respectively). Conclusion The preoperative NLR may be a useful complementary diagnostic tool for predicting pN+ in advanced GC because of its higher sensitivity and NPV than conventional modalities. |
| first_indexed | 2024-12-20T03:37:28Z |
| format | Article |
| id | doaj.art-b379be9fc73c410a9f5bb1e972dad32c |
| institution | Directory Open Access Journal |
| issn | 1471-2407 |
| language | English |
| last_indexed | 2024-12-20T03:37:28Z |
| publishDate | 2019-12-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Cancer |
| spelling | doaj.art-b379be9fc73c410a9f5bb1e972dad32c2022-12-21T19:54:51ZengBMCBMC Cancer1471-24072019-12-011911710.1186/s12885-019-6404-8Clinical significance of neutrophil-to-lymphocyte ratio as a predictor of lymph node metastasis in gastric cancerToshiyuki Kosuga0Tomoki Konishi1Takeshi Kubota2Katsutoshi Shoda3Hirotaka Konishi4Atsushi Shiozaki5Kazuma Okamoto6Hitoshi Fujiwara7Michihiro Kudou8Tomohiro Arita9Ryo Morimura10Yasutoshi Murayama11Yoshiaki Kuriu12Hisashi Ikoma13Masayoshi Nakanishi14Eigo Otsuji15Division of Digestive Surgery, Department of Surgery, Kyoto Prefectural University of MedicineDivision of Digestive Surgery, Department of Surgery, Kyoto Prefectural University of MedicineDivision of Digestive Surgery, Department of Surgery, Kyoto Prefectural University of MedicineDivision of Digestive Surgery, Department of Surgery, Kyoto Prefectural University of MedicineDivision of Digestive Surgery, Department of Surgery, Kyoto Prefectural University of MedicineDivision of Digestive Surgery, Department of Surgery, Kyoto Prefectural University of MedicineDivision of Digestive Surgery, Department of Surgery, Kyoto Prefectural University of MedicineDivision of Digestive Surgery, Department of Surgery, Kyoto Prefectural University of MedicineDivision of Digestive Surgery, Department of Surgery, Kyoto Prefectural University of MedicineDivision of Digestive Surgery, Department of Surgery, Kyoto Prefectural University of MedicineDivision of Digestive Surgery, Department of Surgery, Kyoto Prefectural University of MedicineDivision of Digestive Surgery, Department of Surgery, Kyoto Prefectural University of MedicineDivision of Digestive Surgery, Department of Surgery, Kyoto Prefectural University of MedicineDivision of Digestive Surgery, Department of Surgery, Kyoto Prefectural University of MedicineDivision of Digestive Surgery, Department of Surgery, Kyoto Prefectural University of MedicineDivision of Digestive Surgery, Department of Surgery, Kyoto Prefectural University of MedicineAbstract Background Precise staging is indispensable to select the appropriate treatment strategy for gastric cancer (GC); however, the diagnostic accuracy of conventional modalities needs to be improved. This study investigated the clinical significance of the preoperative neutrophil-to-lymphocyte ratio (NLR) for the prediction of pathological lymph node metastasis (pN+) in GC. Methods This was a retrospective study of 429 patients with GC who underwent curative gastrectomy. The predictive ability of NLR for pN+ was examined in comparison with that of computed tomography. Results The preoperative NLR ranged from 0.6 to 10.8 (median, 2.0), and the optimal cut-off value for predicting pN+ was 1.6 according to the receiver operating characteristic curve with the maximal Youden index. Multivariate analysis identified a NLR ≥ 1.6 (odds ratio (OR) 3.171; 95% confidence interval (CI) 1.448–7.235, p = 0.004) and cN+ (OR 2.426; 95% CI 1.221–4.958, p = 0.011) to be independent factors associated with pN+ in advanced GC (cT2-T4). On the other hand, a NLR ≥ 1.6 was not useful for predicting pN+ in early GC (cT1). In advanced GC, a NLR ≥ 1.6 detected pN+ with a higher sensitivity (84.9%) and negative predictive value (NPV) (63.9%) than conventional modalities (50.0 and 51.7%, respectively). When the subjects were limited to those with advanced GC with cN0, the sensitivity and NPV of a NLR ≥ 1.6 for pN+ increased further (90.7 and 81.0%, respectively). Conclusion The preoperative NLR may be a useful complementary diagnostic tool for predicting pN+ in advanced GC because of its higher sensitivity and NPV than conventional modalities.https://doi.org/10.1186/s12885-019-6404-8Gastric cancerGastrectomyNeutrophil-to-lymphocyte ratioLymph node metastasisStaging |
| spellingShingle | Toshiyuki Kosuga Tomoki Konishi Takeshi Kubota Katsutoshi Shoda Hirotaka Konishi Atsushi Shiozaki Kazuma Okamoto Hitoshi Fujiwara Michihiro Kudou Tomohiro Arita Ryo Morimura Yasutoshi Murayama Yoshiaki Kuriu Hisashi Ikoma Masayoshi Nakanishi Eigo Otsuji Clinical significance of neutrophil-to-lymphocyte ratio as a predictor of lymph node metastasis in gastric cancer BMC Cancer Gastric cancer Gastrectomy Neutrophil-to-lymphocyte ratio Lymph node metastasis Staging |
| title | Clinical significance of neutrophil-to-lymphocyte ratio as a predictor of lymph node metastasis in gastric cancer |
| title_full | Clinical significance of neutrophil-to-lymphocyte ratio as a predictor of lymph node metastasis in gastric cancer |
| title_fullStr | Clinical significance of neutrophil-to-lymphocyte ratio as a predictor of lymph node metastasis in gastric cancer |
| title_full_unstemmed | Clinical significance of neutrophil-to-lymphocyte ratio as a predictor of lymph node metastasis in gastric cancer |
| title_short | Clinical significance of neutrophil-to-lymphocyte ratio as a predictor of lymph node metastasis in gastric cancer |
| title_sort | clinical significance of neutrophil to lymphocyte ratio as a predictor of lymph node metastasis in gastric cancer |
| topic | Gastric cancer Gastrectomy Neutrophil-to-lymphocyte ratio Lymph node metastasis Staging |
| url | https://doi.org/10.1186/s12885-019-6404-8 |
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