Combination Of Lymphocyte Count and Albumin Concentration As A New Prognostic Biomarker For Gastric Cancer

Öz

Aim This research links systemic inflammation and nutritional status with gastric cancer prognosis and postoperative outcomes. Methods Patients undergoing total gastrectomy for gastric adenocarcinoma (2015-2018) were categorized into two: Low Lymphocyte–Albumin(LA) score (Group 1) and High Lymphocyte-Albumin score (Group 2). Demographics, clinical data, operative outcomes, and survival rates were compared. The LA score's predictive ability for lymph node positivity was assessed. Results Using a cut-off value of 6069.7, Group 1 had 59 patients (low value) and Group 2 had 45 (high value). Hospital readmissions due to wound infections were higher in Group 1 (16.9% vs. 2.2%, p=0.041). Both groups had similar tumor localization and total lymph nodes removed, but Group 1 had more positive lymph nodes (4 vs. 2, p=0.026). Survival rates were comparable (32.59 vs. 31.32 months, p=0.390). Conclusion Low LA scores correlate with a higher number of positive lymph nodes, serving as a postoperative quality assessment indicator.

Anahtar Kelimeler

• Gastric Cancer
• Prognosis
• Complication
• Albumin
• Lymphocyte Count

Kaynakça

1. 1. Ferlay J, Colombet M, Soerjomataram I, et al. Estimating the global cancer incidence and mortality in 2018: GLOBOCAN sources and methods. Int J Cancer. 2019;144(8):1941-1953. DOI: 10.1002/ijc.31937.
2. 2. Allemani C, Matsuda T, Di Carlo V, et al. Global surveillance of trends in cancer survival 2000-14 (CONCORD-3): analysis of individual records for 37,513,025 patients diagnosed with one of 18 cancers from 322 population-based registries in 71 countries. Lancet. 2018;391(10125):1023–1075. DOI: 10.1016/S0140-6736(17)33326-3.
3. 3. In H, Solsky I, Palis B, et al. Validation of the 8th Edition of the AJCC TNM Staging System for Gastric Cancer using the National Cancer Database. Ann Surg Oncol. 2017;24(12):3683–3691. DOI: 10.1245/s10434-017-6078-x.
4. 4. Guo YX, Zhang ZZ, Zhao G, et al. Prognostic and pathological impact of tumor budding in gastric cancer: A systematic review and meta-analysis. World J Gastrointest Oncol. 2019;11(10):898–908. DOI: 10.4251/wjgo.v11.i10.898.
5. 5. Yamamoto T, Kawada K, Hida K, et al. Combination of lymphocyte count and albumin concentration as a new prognostic biomarker for rectal cancer. Sci Rep. 2021;11(1):5027. DOI: 10.1038/s41598-021-84475-4.
6. 6. Chen XL, Xue L, Wang W, et al. Prognostic significance of the combination of preoperative hemoglobin, albumin, lymphocyte and platelet in patients with gastric carcinoma: a retrospective cohort study. Oncotarget. 2015;6(38):41370–41382. DOI: 10.18632/oncotarget.5629.
7. 7. Mantovani A, Allavena P, Sica A, et al. Cancer-related inflammation. Nature. 2008;454(7203):436–444. DOI: 10.1038/nature07205.
8. 8. Gupta D, Lis CG. Pretreatment serum albumin as a predictor of cancer survival: a systematic review of the epidemiological literature. Nutr J. 2010;9:69. DOI: 10.1186/1475-2891-9-69.

9. 9. Dindo D, Demartines N, Clavien PA. Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg. 2004;240(2):205–213. DOI: 10.1097/01.sla.0000133083.54934.ae.
10. 10. Kang SC, Kim HI, Kim MG. Low Serum Albumin Level, Male Sex, and Total Gastrectomy Are Risk Factors of Severe Postoperative Complications in Elderly Gastric Cancer Patients. J Gastric Cancer. 2016;16(1):43–50. DOI: 10.5230/jgc.2016.16.1.43.
11. 11. Gibbs J, Cull W, Henderson W, et al. Preoperative serum albumin level as a predictor of operative mortality and morbidity: results from the National VA Surgical Risk Study. Arch Surg. 1999;134(1):36–42. DOI: 10.1001/archsurg.134.1.36.
12. 12. Ouyang X, Dang Y, Zhang F, Huang Q. Low Serum Albumin Correlates with Poor Survival in Gastric Cancer Patients. Clin Lab. 2018;64(3):239–245. DOI: 10.7754/Clin.Lab.2017.170804.
13. 13. Liu Q, Peng J, Jiang HG, et al. [Title in Chinese]. Zhonghua Zhong Liu Za Zhi. 2019;41(8):599–603. DOI: 10.3760/cma.j.issn.0253-3766.2019.08.008.
14. 14. Huamán Manuel, Cerna-Barco Jorge, Correa-Lopez Lucy, et al. Albumina e índice neutrófilo-linfocito como predictores de estadío tumoral en pacientes con cáncer gástrico. Rev Fac Med Hum. 2020;20:96-113. DOI: 10.25176/RFMH.v20i2.2936.
15. 15. Wang SC, Chou JF, Strong VE, et al. Pretreatment Neutrophil to Lymphocyte Ratio Independently Predicts Disease-specific Survival in Resectable Gastroesophageal Junction and Gastric Adenocarcinoma. Ann Surg. 2016;263(2):292–297. DOI: 10.1097/SLA.0000000000001189.
16. 16. Quigley DA, Kristensen V. Predicting prognosis and therapeutic response from interactions between lymphocytes and tumor cells. Mol Oncol. 2015;9(10):2054–2062. DOI: 10.1016/j.molonc.2015.10.003.
17. 17. Feng F, Zheng G, Wang Q, et al. Low lymphocyte count and high monocyte count predicts poor prognosis of gastric cancer. BMC Gastroenterol. 2018;18(1):148. DOI: 10.1186/s12876-018-0877-9.
18. 18. Schroth J, Weber V, Jones TF, et al. Preoperative lymphopaenia, mortality, and morbidity after elective surgery: systematic review and meta-analysis. Br J Anaesth. 2021;127(1):32–40. DOI: 10.1016/j.bja.2021.02.023.
19. 19. Xu Z, Cheng H. Research progress of peripheral blood count test in the evaluation of prognosis of gastric cancer. Zhonghua Wei Chang Wai Ke Za Zhi. 2017;20(2):236-240.