tjcl Turkish Journal of Clinics and Laboratory 2149-8296 DNT Ortadoğu Yayıncılık A.Ş. 10.18663/tjcl.1221028 Health Care Administration Sağlık Kurumları Yönetimi Tam Kan Sayımı Parametreleri ile İleri Evre Mide Kanseri Olan Hastaların Prognozunu Tahmin Edilebilir Mi? Parameters of Complete Blood Count Might Predict the Prognosis of Patients with Advanced Gastric Cancer Sütçüoğlu Osman GAZİ ÜNİVERSİTESİ Fincan Abdülkadir GAZİ ÜNİVERSİTESİ Gürler Fatih GAZİ ÜNİVERSİTESİ Kurt İnci Bediz GAZİ ÜNİVERSİTESİ Yıldırım Özdemir Nuriye GAZİ ÜNİVERSİTESİ Yazıcı Ozan GAZİ ÜNİVERSİTESİ 06 30 2023 14 2 243 245 12 20 2022 05 16 2023 Copyright © 2010, Turkish Journal of Clinics and Laboratory 2010 Turkish Journal of Clinics and Laboratory

Amaç: Metastatik mide kanseri sık görülen ve prognozu kötü olan bir hastalıktır. Bu yaygın hastalıkta prognozun basit bir tam kan sayımı ile tahmin edilmesi birçok çalışmada dikkatleri üzerine çekmiştir. Ancak çalışmaların sonuçları birbiriyle uyumlu değildir. Bu çalışmanın amacı, ilerlemiş mide kanserli (İMK) hastalarda tam kan sayımı parametreleri ile hastalık prognozu arasındaki ilişkiyi değerlendirmektir.Gereç ve Yöntemler: Hastaların İMK tanısı anında herhangi bir tedavi almadan önce kan sayımları incelendi. Tam kan sayımından elde edilen tüm parametreler kayıt edildi; Nötrofil lenfosit oranı (NLR), trombosit lenfosit oranı (PLR), monosit lenfosit oranı (MLR), sistemik immün-enflamasyon indeksi (SII). Hastalar medyan NLR, PLR, MLR ve SII değerlerine göre iki alt gruba ayrıldı.Bulgular: Çalışmaya İMK'li toplam 105 hasta dahil edildi. Düşük NLR grubundaki hastalarda medyan sağkalım 14,6 ay iken, yüksek NLR grubunda 7,9 aydı (p=0,008). Ortanca sağkalım düşük PLR grubunda 12.7 aya karşı yüksek PLR grubunda 8.2 aydı (p=0.019). Ortanca sağkalım süresi yüksek MLR grubunda 14.6 ay iken, düşük MLR grubunda 7.9 aydı (p=0.06).Sonuç: Tam kan sayımından elde edilen parametreler aracılığıyla NLR, İMK'li hastalarda umut verici bir prognostik belirteç gibi görünmektedir.

Metastatic gastric cancer is a common disease with poor prognosis. In this common disease, estimating the prognosis with a simple complete blood count has attracted the attention in many studies. However, the results of the studies are incompatible with each other. The aim of the study was to evaluate the relationship between parameters of the complete blood count and disease prognosis in patients with advanced gastric cancer(AGC). Blood counts of the patients were examined before receiving any treatment at the time of diagnosis of AGC. All parameters derived from complete blood count. These were; Neutrophil lymphocyte ratio(NLR), platelet lymphocyte ratio(PLR),monocyte lymphocyte ratio(MLR), systemic immune-inflammation index(SII). The patients were divided in two subgroups according to the median values of NLR, PLR, MLR and SII. A total of 105 patients with AGC were included in the study. The median survival in the patients with low NLR group was 14.6 months compared with high NLR group was 7.9 months(p=0.008). In low PLR and MLR group the median survivals were 12.7 and 14.6 months compared with high PLR and MLR were 8.2 and 7.9 months respectively(p=0.019,p=0.06). Through the parameters derived from complete blood count, NLR appears to be a promising prognostic marker in patients with AGC.

 mide kanseri inflamasyon nötrofil genel sağkalım nötrofil-lenfosit oranı tam kan sayımı gastric cancer neutrophil overall survival prognosis yoktur yoktur 1. Van Cutsem E, Sagaert X, Topal B, Haustermans K, Prenen H. Gastric cancer. Lancet. 2016;388(10060):2654-64.10.1016/s0140-6736(16)30354-3. 2. Yamamura Y, Nakajima T, Ohta K, Nashimoto A, Arai K, Hiratsuka M, et al. Determining prognostic factors for gastric cancer using the regression tree method. Gastric Cancer. 2002;5(4):201-7.10.1007/s101200200035. 3. Ma X, Zhang C, Wang C, Miao W, Zhou W, An J, et al. Comparison of clinicopathologic profiles and prognosis of gastric cancer in the upper, middle and lower third of the stomach: A retrospective cohort study. Medicine. 2020;99(30) 4. Galli F, Aguilera JV, Palermo B, Markovic SN, Nisticò P, Signore A. Relevance of immune cell and tumor microenvironment imaging in the new era of immunotherapy. Journal of Experimental & Clinical Cancer Research. 2020;39(1):1-21 5. Garner H, de Visser KE. Immune crosstalk in cancer progression and metastatic spread: a complex conversation. Nature Reviews Immunology. 2020:1-15 6. Yufei Y, Mingli L, Xuejiao L, Xuemei D, Yiming J, Qin Q, et al. Utility of the neutrophil-to-lymphocyte ratio and C-reactive protein level for coronavirus disease 2019 (COVID-19). Scandinavian journal of clinical and laboratory investigation. 2020:1-5 7. Yarchoan M, Hopkins A, Jaffee EM. Tumor mutational burden and response rate to PD-1 inhibition. The New England journal of medicine. 2017;377(25):2500 8. Guo J, Chen S, Chen Y, Li S, Xu D. Combination of CRP and NLR: a better predictor of postoperative survival in patients with gastric cancer. Cancer management and research. 2018;10:315 9. Lee DY, Hong SW, Chang YG, Lee WY, Lee B. Clinical significance of preoperative inflammatory parameters in gastric cancer patients. Journal of gastric cancer. 2013;13(2):111-6 10. Cheng C-b, Zhang Q-x, Zhuang L-P, Sun J-w. Prognostic value of lymphocyte-to-C-reactive protein ratio in patients with gastric cancer after surgery: a multicentre study. Japanese Journal of Clinical Oncology. 2020;50(10):1141-9.10.1093/jjco/hyaa099. 11. Ozyurek BA, Ozdemirel TS, Ozden SB, Erdogan Y, Kaplan B, Kaplan T. Prognostic value of the neutrophil to lymphocyte ratio (NLR) in lung cancer cases. Asian Pacific Journal of Cancer Prevention: APJCP. 2017;18(5):1417 12. Guthrie GJ, Charles KA, Roxburgh CS, Horgan PG, McMillan DC, Clarke SJ. The systemic inflammation-based neutrophil–lymphocyte ratio: experience in patients with cancer. Critical reviews in oncology/hematology. 2013;88(1):218-30 13. Walsh S, Cook E, Goulder F, Justin T, Keeling N. Neutrophil‐lymphocyte ratio as a prognostic factor in colorectal cancer. Journal of surgical oncology. 2005;91(3):181-4 14. Kim EY, Lee JW, Yoo HM, Park CH, Song KY. The platelet-to-lymphocyte ratio versus neutrophil-to-lymphocyte ratio: which is better as a prognostic factor in gastric cancer? Annals of surgical oncology. 2015;22(13):4363-70 15. Chan JC, Chan DL, Diakos CI, Engel A, Pavlakis N, Gill A, et al. The lymphocyte-to-monocyte ratio is a superior predictor of overall survival in comparison to established biomarkers of resectable colorectal cancer. Annals of surgery. 2017;265(3):539 16. Jomrich G, Gruber ES, Winkler D, Hollenstein M, Gnant M, Sahora K, et al. Systemic Immune-Inflammation Index (SII) predicts poor survival in pancreatic cancer patients undergoing resection. Journal of Gastrointestinal Surgery. 2019:1-9 17. Krenn-Pilko S, Langsenlehner U, Thurner E, Stojakovic T, Pichler M, Gerger A, et al. The elevated preoperative platelet-to-lymphocyte ratio predicts poor prognosis in breast cancer patients. British journal of cancer. 2014;110(10):2524-30 18. Ding N, Pang Z, Shen H, Ni Y, Du J, Liu Q. The prognostic value of PLR in lung cancer, a meta-analysis based on results from a large consecutive cohort. Scientific reports. 2016;6:34823 19. Xu Z, Xu W, Cheng H, Shen W, Ying J, Cheng F, et al. The prognostic role of the platelet-lymphocytes ratio in gastric cancer: a meta-analysis. PloS one. 2016;11(9):e0163719 20. Zhang X, Zhang W, Feng L-j. Prognostic significance of neutrophil lymphocyte ratio in patients with gastric cancer: a meta-analysis. PloS one. 2014;9(11):e111906 21. Cho IR, Park JC, Park CH, Jo JH, Lee HJ, Kim S, et al. Pre-treatment neutrophil to lymphocyte ratio as a prognostic marker to predict chemotherapeutic response and survival outcomes in metastatic advanced gastric cancer. Gastric cancer. 2014;17(4):703-10 22. Miyamoto R, Inagawa S, Sano N, Tadano S, Adachi S, Yamamoto M. The neutrophil-to-lymphocyte ratio (NLR) predicts short-term and long-term outcomes in gastric cancer patients. European Journal of Surgical Oncology. 2018;44(5):607-12 23. Jin H, Zhang G, Liu X, Liu X, Chen C, Yu H, et al. Blood neutrophil-lymphocyte ratio predicts survival for stages III-IV gastric cancer treated with neoadjuvant chemotherapy. World journal of surgical oncology. 2013;11(1):112 24. Graziosi L, Marino E, De Angelis V, Rebonato A, Cavazzoni E, Donini A. Prognostic value of preoperative neutrophils to lymphocytes ratio in patients resected for gastric cancer. The American Journal of Surgery. 2015;209(2):333-7 25. Balkwill F, Mantovani A. Inflammation and cancer: back to Virchow? The lancet. 2001;357(9255):539-45 26. Deans C, Wigmore SJ. Systemic inflammation, cachexia and prognosis in patients with cancer. Current Opinion in Clinical Nutrition & Metabolic Care. 2005;8(3):265-9 27. Ghiringhelli F, Rebe C, Hichami A, Delmas D. Immunomodulation and anti-inflammatory roles of polyphenols as anticancer agents. Anti-Cancer Agents in Medicinal Chemistry (Formerly Current Medicinal Chemistry-Anti-Cancer Agents). 2012;12(8):852-73 28. Schmidt H, Bastholt L, Geertsen P, Christensen IJ, Larsen S, Gehl J, et al. Elevated neutrophil and monocyte counts in peripheral blood are associated with poor survival in patients with metastatic melanoma: a prognostic model. British journal of cancer. 2005;93(3):273-8 29. Tsai YD, Wang CP, Chen CY, Lin LW, Hwang TZ, Lu LF, et al. Pretreatment circulating monocyte count associated with poor prognosis in patients with oral cavity cancer. Head & neck. 2014;36(7):947-53 30. Hu P, Shen H, Wang G, Zhang P, Liu Q, Du J. Prognostic significance of systemic inflammation-based lymphocyte-monocyte ratio in patients with lung cancer: based on a large cohort study. PloS one. 2014;9(10):e108062 31. Chen L, Yan Y, Zhu L, Cong X, Li S, Song S, et al. Systemic immune–inflammation index as a useful prognostic indicator predicts survival in patients with advanced gastric cancer treated with neoadjuvant chemotherapy. Cancer management and research. 2017;9:849 32. Zhou D, Wu Y, Zhu Y, Lin Z, Yu D, Zhang T. The Prognostic Value of Neutrophil-to-lymphocyte Ratio and Monocyte-to-lymphocyte Ratio in Metastatic Gastric Cancer Treated with Systemic Chemotherapy. Journal of Cancer. 2020;11(14):4205 33. Sachlova M, Majek O, Tucek S. Prognostic value of scores based on malnutrition or systemic inflammatory response in patients with metastatic or recurrent gastric cancer. Nutrition and cancer. 2014;66(8):1362-70