Clinical Value of PLR, MLR, and NWR in Neoadjuvant Chemotherapy for Locally Advanced Gastric Cancer

Abstract

Objective. The clinical value of platelet-to-lymphocyte ratio (PLR), monocyte-to-lymphocyte ratio (MLR), and neutrophil-to-white blood cell ratio (NWR) in predicting the prognosis of patients with locally advanced gastric cancer after neoadjuvant chemotherapy (NACT) was studied. Methods. A total of 131 patients with locally advanced gastric cancer treated with neoadjuvant chemotherapy in our hospital from May 2015 to June 2018 were selected as the study subjects, and all were treated with neoadjuvant chemotherapy. The relationship between the values of PLR, MLR, and NWR and the efficacy of neoadjuvant chemotherapy and clinical staging was analyzed; all patients were followed up for 3 years. Patients were divided into death group and survival group according to the survival of patients. The predictive value of PLR, MLR, and NWR values for patients’ prognosis was analyzed, and the survival rates of patients with different PLR, MLR, and NWR values were compared. Results. The effective rate of neoadjuvant chemotherapy in patients with locally advanced gastric cancer was 62.60% (82/131), and the PLR, MLR, and NWR values in the effective group were lower than those in the ineffective group ( $P<0.05$ ). The AUC of combined PLR, MLR, and NWR in evaluating the efficacy of neoadjuvant chemotherapy was greater than that of PLR and NWR alone ( $P<0.05$ ). The PLR value of patients with stage IIIa, IIIb, and IIIc was greater than that of patients with stage II, the MLR value of patients with stage IIIb and IIIc was greater than that of patients with stage II and IIIa, and the NMR value of patients with stage IIIc was greater than that of patients with stage II, IIIa, and IIIb ( $P<0.05$ ). PLR, MLR, and NWR values were positively correlated with clinical stage ( $P<0.05$ ). The PLR, MLR, and NWR values in the survival group were lower than those in the death group ( $P<0.05$ ). The AUC of combined PLR, MLR, and NWR in predicting the prognosis of patients was greater than that of MLR and NWR alone ( $P<0.05$ ). The survival rate of patients with $\text{PLR}\ge 162.11$ (36.21%) was lower than that of patients with $\text{PLR}<162.11$ (80.82%), and the survival rate of patients with $\text{MLR}\ge 0.31$ (42.86%) was lower than that of patients with $\text{MLR}<0.31$ (74.67%), and the survival rate of patients with $\text{NWR}\ge 0.62$ (45.00%) was lower than that of patients with $\text{NWR}<0.62$ (74.65%) ( $P<0.05$ ). Conclusions. PLR, MLR, and NWR values are correlated with clinical stage, and the combined detection has value in evaluating the clinical efficacy of neoadjuvant chemotherapy and predicting the prognosis of patients with locally advanced gastric cancer.