Prognostic Value of PLR-HRR Score in Postoperative Patients with Gastric Cancer
Objective To investigate the predictive value of the PLR-HRR score,which consists of the combination of absolute platelet/lymphocyte ratio(PLR)and hemoglobin/red cell distribution width ratio(HRR),on the survival of patients after R0 resection for gastric cancer.Methods The clinicopathological data of 146 gastric cancer patients who underwent adjuvant chemotherapy after R0 resection of gastric cancer in the General Hospital of Ningxia Medical University from January 1,2019 to June 30,2020 were retrospectively collected.The optimal cut-off values of PLR and HRR were determined by applying ROC curves for grouping and establishment of PLR-HRR scores.The correlation between different PLR-HRR scores and clinicopathological characteristics of gastric cancer patients were compared.The Kaplan-Meier survival curve and COX risk regression were used to assess the application value of the PLR-HRR score in the prognosis of patients with gastric cancer after R0 resection of gastric cancer.A survival rate prognosis model based on PLR-HRR score was established,and the C-index of the model was calculated.The ROC curve was drawn to evaluate the model discrimination,and the decision analysis curve(DCA)and clinical impact curve(CIC)were drawn to evaluate the clinical efficacy of the nomogram model.Results The optimal cut-off values of PLR and HRR for predicting the survival rate of gastric cancer patients were 186.09 and 9.85 respectively.The patients were divided into three groups:40 patients in the PLR-HRR 0 group(PLR＜186.09 and HRR≥9.85);73 patients in the PLR-HRR 1 group(PLR≥186.09 and HRR≥9.85 or PLR＜186.09 and HRR＜9.85);33 patients in the PLR-HRR 2 group(PLR≥186.09 and HRR＜9.85).PLR-HRR score was correlated with tumor maximum diameter,TNM stage,PLR,and HRR(P all＜0.05).The results of Kaplan-Meier survival curve showed that the 3-year survival rates of PLR-HRR score of 0,1 and 2 were 84.0%,61.5%and 14.6%respectively,and the difference was statistically significant(P＜0.001).Multifactorial COX regression analysis showed that ascites,maximum tumor diameter≥5 cm,TNM stageⅣ,and PLR-HRR score 2 were influencing factors affecting the survival of patients after R0 resection for gastric cancer(P all＜0.05).The C-index of the Nomogram constructed based on PLR-HRR and other influencing factors was C-index=0.767(95%CI:0.711-0.823).The ROC curve showed good model differentiation,and the DCA and CIC curves showed that the predictive model provided significant benefits over most of the threshold probability range.Conclusion The PLR-HRR score can be used as a reliable index to assess the prognosis of patients after R0 resection for gastric cancer,with higher scores suggesting a worse prognosis for patients.The Nomogram constructed based on PLR-HRR and other influencing factors has good predictive ability.
gastric cancerplatelet/lymphocyte ratiohemoglobin/red cell distribution width ratio
万方数据
维普
