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The predicting value of pretreatment neutrophil count and lymphocyte-to-monocyte ratio in peripheral blood for the pathological tumor responses in patients with locally advanced gastric adenocarcinoma after preoperative therapy
1Department of Radiation Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in Southern China, Guangzhou 510060, China; 2Department of Gastric Surgery, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in Southern China, Guangzhou 510060, China
AbstractObjective To analyze the predicting values of hematological indicators for the pathological response in patients with gastric adenocarcinoma after preoperative neoadjuvant therapy and radical surgery. Methods The absolute count of neutrophils (NE), lymphocytes (LY) and monocytes (MO) of 102 patients with locally advanced gastric adenocarcinoma in a multi-center randomized phase Ⅲ clinical trial (NCT01815853) from June 2013 to Feburary 2019 were retrospectively analyzed. Patients were divided into the chemotherapy alone group (ChT, 3 cycles of XELOX regimen) and the chemoradiation group (CRT, 1 cycle of induced XELOX regimen and 4500 cGy/25f radiotherapy plus concurrent extenuated 2 cycles of XELOX regimen), 51 cases in each group. The pathological response indicators of tumors after radical surgery included tumor regression grade, pathological complete regression, pathological T stage (ypT), N stage (ypN) and TNM stage (ypTNM). Results Univariate regression analysis and ROC curves demonstrated a significant association between the absolute neutrophil count (NE) and ypT, lymphocyte-to-monocyte ratio (LMR) and ypN0, and LMR and ypTNM reduction in the entire cohort of patients. Multivariate regression analysis showed that higher NE (>4.10×109/L) was significantly associated with higher probability of ypT reduction (OR=3.308, P=0.007). Higher LMR (>3.46) was significantly associated with higher ypN0 probability (OR=4.276, P=0.005) and better ypTNM reduction (OR=2.805, P=0.019). In subgroup analysis, higher NE (>4.10) was significantly correlated with higher probability of ypT reduction (OR=3.750, P=0.030) in the CRT group, and higher LMR (>3.46) was significantly associated with higher ypN0 probability (OR=8.500, P=0.050) and the probability of ypTNM stage reduction (OR=4.000, P=0.026) in the ChT group. Conclusions Pretreatment NE and LMR in the peripheral blood serve as independent predictors for tumor pathological responses after preoperative treatment, and immune condition is correlated with tumor regression after radical surgery in patients with locally advanced gastric cancer.
Li Nai,Zhang Yujing,Fang Yi et al. The predicting value of pretreatment neutrophil count and lymphocyte-to-monocyte ratio in peripheral blood for the pathological tumor responses in patients with locally advanced gastric adenocarcinoma after preoperative therapy[J]. Chinese Journal of Radiation Oncology, 2021, 30(4): 363-367.
Li Nai,Zhang Yujing,Fang Yi et al. The predicting value of pretreatment neutrophil count and lymphocyte-to-monocyte ratio in peripheral blood for the pathological tumor responses in patients with locally advanced gastric adenocarcinoma after preoperative therapy[J]. Chinese Journal of Radiation Oncology, 2021, 30(4): 363-367.
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