Predictive Value of Neutrophil-To-Lymphocyte Ratio for Distant Metastasis in Gastric Cancer Patients

Purpose: We aim to investigate the clinical significance of NLR in predicting gastric cancer (GC) metastasis. Methods Clinical data from 1,667 consecutive GC patients were retrospectively analyzed. The cut-off was calculated from the receiver operating characteristics (ROC) curve with the maximal Youden index. Prediction probability was obtained by binary logistic regression of GC markers (CEA, CA19-9 and CA72-4) with (P1) or without NLR (P2). Diagnostic efficacy of indicators as well as prediction probability was estimated and compared by ROC analysis. Clinicopathological parameters including inflammatory markers were evaluated for distant metastasis using multiple logistic regression analysis. Results The optimal cut-off for NLR was 2.91 with 55% sensitivity and 73.4% specificity. P2 had significantly higher efficacy than P1 for peritoneal metastasis (P = 0.013), osseous metastasis (P = 0.017) and hepatic metastasis (P < 0.001). In multiple logistic regression analysis, age (OR: 0.68, 95% CI: 0.547–0.844), NLR (OR: 2.858, 95% CI: 2.295–3.559), CEA (OR: 2.108, 95% CI: 1.671–2.661), CA19-9 (OR: 1.844, 95% CI: 1.466–2.32), CA72-4 (OR: 2.348, 95% CI: 1.851–2.978) were found to be significantly associated with GC metastasis. Conclusion NLR was a risk factor of GC metastasis. Combining CEA, CA19-9, CA72-4 and NLR could better predict metastases in GC.