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. 2021 Jan 9:2021:8729869.
doi: 10.1155/2021/8729869. eCollection 2021.

The Ratio of the Hemoglobin to Red Cell Distribution Width Combined with the Ratio of Platelets to Lymphocytes Can Predict the Survival of Patients with Gastric Cancer Liver Metastasis

Zhao Zhai  1 , Jialiang Gao  1 , Ziyu Zhu  1 , Xiliang Cong  1 , Shenghan Lou  1 , Bangling Han  1 , Xin Yin  1 , Yu Zhang  1 , Yingwei Xue  1
Affiliations

The Ratio of the Hemoglobin to Red Cell Distribution Width Combined with the Ratio of Platelets to Lymphocytes Can Predict the Survival of Patients with Gastric Cancer Liver Metastasis

Zhao Zhai et al. Biomed Res Int. .

Abstract

Background: Hemoglobin/red cell distribution width (HR) and platelet/lymphocyte (PLR) ratios are considered effective prognostic markers in various cancers. We have proposed a new prognostic parameter: HR+PLR. The aim of this study is to explore the prognostic value of the HR+PLR scoring system in patients with gastric cancer liver metastasis.

Methods: This study retrospectively analyzed the clinical data of 306 patients with gastric cancer liver metastases admitted to our hospital from 2007 to 2014. According to the size of HR value and PLR value, we will divide the patients into three groups, namely, HR+PLR: (1) 0 points: HR > 1.02 and PLR < 128; (2) 1 point: HR > 1.02 and PLR > 128 and HR < 1.02 and PLR < 128; and (3) 2 points: HR < 1.02 and PLR > 128.

Results: The HR+PLR score was statistically different from age (P = 0.049), T stage (P < 0.001), N stage (P = 0.017), number of liver metastases (P = 0.018), gastrectomy (P < 0.001), hepatectomy (P = 0.001), peritoneal metastasis (P = 0.012), prognostic nutritional index (PNI) (P = 0.028), and neutrophil/lymphocyte ratio (NLR) (P = 0.045). The HR+PLR scoring system has a higher area under the ROC curve (AUC value) than PNI, PLR, HR, and PLR (AUC = 0.798, P < 0.001). In multivariate analysis, gastrectomy (P = 0.001), hepatectomy (P < 0.001), chemotherapy (P = 0.014), and HR+PLR score (P < 0.001) were considered independent prognostic factors.

Conclusion: For patients with gastric cancer liver metastasis, the HR+PLR score is a simple, reliable, and economic prognostic marker.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Figure 1
Figure 1
The prognostic analysis of GCLM obtained from our study first classifies patients by whether they have undergone gastrectomy and then classifies patients by whether they have undergone hepatectomy.
Figure 2
Figure 2
Survival ROC curve (P value) for HR and PLR: (a) HR (P < 0.001); (b) PLR (P < 0.001).
Figure 3
Figure 3
Kaplan–Meier curve for OS (overall survival) of 306 GCLM patients stratified by HR and PLR: (a) HR (P < 0.001); (b) PLR (P < 0.001).
Figure 4
Figure 4
Kaplan–Meier curve for OS (overall survival) of 306 GCLM patients stratified by HR+PLR.
Figure 5
Figure 5
Comparison of prognostic value between the HR+PLR score and other prognostic factors.
Figure 6
Figure 6
Kaplan–Meier curve for OS (overall survival) of GCLM patients stratified by HR+PLR: (a) 81 GCLM patients undergoing hepatectomy (P < 0.001); (b) 225 GCLM patients without hepatectomy (P < 0.001).
Figure 7
Figure 7
Kaplan–Meier curve for OS (overall survival) of GCLM patients stratified by HR+PLR: (a) 138 GCLM patients undergoing postoperative chemotherapy (P < 0.001); (b) 168 GCLM patients without postoperative chemotherapy (P < 0.001).
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