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

Abstract

Objective: 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. Methods: Study participants were identified from a prospective cohort of patients with advanced gastric cancer in Japan (n = 1,220). Results: The median baseline N/L was 2.58 (range, 0.63–12.7). Univariate analysis revealed that patients with an N/L ≧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 × 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 × 10–8). Conclusions: 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.