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Sarcopenia is associated with the neutrophil/lymphocyte and platelet/lymphocyte ratios in operable gastric cancer patients: a prospective study

Authors Lin J, Zhang W, Huang Y, Chen W, Wu R, Chen X, Lou N, Wang P

Received 26 May 2018

Accepted for publication 29 July 2018

Published 25 October 2018 Volume 2018:10 Pages 4935—4944

DOI https://doi.org/10.2147/CMAR.S175421

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Colin Mak

Peer reviewer comments 2

Editor who approved publication: Professor Nakshatri


Ji Lin,1,* Weiteng Zhang,1,* Yunshi Huang,1 Weisheng Chen,1 Ruisen Wu,1 Xiaodong Chen,1 Neng Lou,2 Pengfei Wang1

1Department of Gastrointestinal Surgery, The First Affiliated Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China; 2Department of General Surgery, Zhejiang University Huzhou Hospital, Huzhou, Zhejiang, China

*These authors contributed equally to this work

Purpose: Sarcopenia is distinguished by decreased skeletal muscle plus low muscle strength and/or physical performance. This study was designed to demonstrate the relationship between sarcopenia and systemic inflammatory response (neutrophil/lymphocyte ratio [NLR], platelet/lymphocyte ratio [PLR], and large platelet/lymphocyte ratio [LPLR]) prior to radical gastrectomy for gastric cancer.
Patients and methods: We conducted a prospective study of gastric cancer patients who underwent radical gastrectomy. The clinical utility of the NLR, PLR, and LPLR was evaluated by receiver operating characteristic curves. Sarcopenia components including skeletal muscle index, handgrip strength, and 6 m usual gait speed were measured. Logistic analysis was used to identify the independent indices associated with sarcopenia.
Results: A total of 670 patients were included, representing 504 men and 166 women. Of these, 104 patients (15.5%) were diagnosed with sarcopenia and 567 (84.5%) were non-sarcopenia. PLR has a diagnostic sensitivity of 91.3% for sarcopenia. In addition to the indicators of preoperative age, nutritional risk screening, body mass index, preoperative albumin, and diabetes, the NLR and PLR were independent predictors for sarcopenia (P<0.05).
Conclusion: The present study showed that at-diagnosis sarcopenia was associated with inflammation in patients with operable gastric cancer. Due to the complex assessment of muscle condition, PLR may be used as a primary screening test for sarcopenia. How systemic inflammatory response influences changes in sarcopenia may provide new therapeutic perception toward improving outcomes.

Keywords: gastric cancer, sarcopenia, neutrophil/lymphocyte ratio, platelet/lymphocyte ratio

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