The Baseline Ratio of Neutrophils to Lymphocytes Is Associated with Patient Prognosis in Advanced Gastric Cancer

Abstract

In cancer patients, the balance between neutrophil (N) and lymphocyte (L) cell counts fluctuates with advancing disease. The objective of our study was to determine the prognostic implications of the N/L ratio in the peripheral blood of gastric cancer patients. Study participants were identified from a prospective cohort of patients with advanced gastric cancer in Japan (n = 1,220). The median baseline N/L was 2.58 (range, 0.63-12.7). Univariate analysis revealed that patients with an N/L > pr =2.5 (n = 644) had a significantly poorer prognosis than those with an N/L <2.5 (n = 576; log rank test, p = 0.019 x 10(-12)). The median survival times for these two groups were 239 (95% confidence interval, CI, 217-251 days) and 363 days (95% CI, 334-406 days), respectively, while the 1-year survival rates were 30 (95% CI, 26-34%) and 50% (95% CI, 45-54%), respectively. A multivariate Cox model established a significant relationship between the N/L ratio and survival (adjusted hazard ratio = 1.52; 95% CI, 1.32-1.75; p = 0.077 x 10(-8)). These results suggest that the N/L ratio is an independent prognostic factor in advanced gastric cancer. Measurement of this ratio may serve as a clinically accessible and useful biomarker for patient survival.