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Combination of CRP and NLR: a better predictor of postoperative survival in patients with gastric cancer

Authors Guo J, Chen S, Chen Y, Li S, Xu D

Received 4 November 2017

Accepted for publication 19 December 2017

Published 14 February 2018 Volume 2018:10 Pages 315—321


Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 4

Editor who approved publication: Professor Lu-Zhe Sun

Jing Guo,1,2,* Shangxiang Chen,1,2,* Yongming Chen,1,2,* Shun Li,1,2 Dazhi Xu1,2

1State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, People’s Republic of China; 2Department of Gastric Surgery, Sun Yat-Sen University Cancer Center, Guangzhou, People’s Republic of China

*These authors contributed equally to this work

C-reactive protein (CRP) and neutrophil to lymphocyte ratio (NLR) were independent predictive factors for gastric cancer (GC). Our study was designed to prove the prognostic value of the combination of CRP and NLR (COC-NLR) in GC patients.
Materials and methods: A total of 1,058 GC patients who underwent D2 resection from Sun Yat-Sen University Cancer Center between 2003 and 2013 were included. They were divided into three groups (low: NLR ≤2.5, CRP ≤6.1; medium: NLR >2.5, CRP ≤4.5; high: NLR >2.5, CRP >4.5 or NLR ≤2.5, CRP >6.1) by the random forest method. Survival analysis stratified by COC-NLR groups was performed.
Results: The mean survival time for each group was: for the low group 75.44 months (95% CI: 72.48–78.40), the medium group 56.50 months (95% CI: 50.68–62.31), and the high group 38.65 months (95% CI: 34.51–42.97). The low group showed obviously better overall survival (OS) than other two groups (p<0.001). Survival analysis showed that COC-NLR had statistical significance in both univariate and multivariate analyses (p<0.01).
Conclusion: This study showed that COC-NLR could work as an independent prognostic factor in GC and provide more accurate prediction than single NLR or CRP. 

Keywords: inflammation index, NLR, CRP, combination, prognosis, gastric cancer

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