Circulating tumor cell with neutrophil to lymphocyte ratio in predicting efficacy of advanced gastric cancer

Abstract

Objective To investigate the predictive effect of circulating tumor cell (CTC) combined with neutrophil to lymphocyte ratio (NLR) on efficacy of advanced gastric cancer. Methods The clinicopathological data of 36 patients with advanced gastric cancer who received firstline treatment in Jiangning Hospital Affiliated to Nanjing Medical University and Jiangsu Cancer Hospital from June 2022 to January 2023 were collected. The optimal cutoff values of CTC and NLR were calculated using X-tile software, and the patients were divided into high CTC group (CTC>15, n=21) and low CTC group (CTC≤15, n=15), high NLR group (NLR>2.32, n=20) and low NLR group (NLR≤2.32, n=16). COX regression analysis and survival curve were used to analyze the relationship between CTC, NLR and progression free survival (PFS). Receiver operating characteristic (ROC) curves compared the predictive power of CTC, NLR, and the combination in predicting the outcome of advanced gastric cancer. Results Multivariate COX regression analysis showed that CTC (HR=7.441, P=0.045) and NLR (HR=4.690, P=0.011) were associated with PFS in patients with advanced gastric cancer. Patients in CTC group and low NLR group had longer PFS than those in high CTC group and high NLR group, respectively (P<0.01). Patients with both high CTC and high NLR had the shortest PFS (P<0.01). Compared with the singlefactor prediction, the combination of CTC and NLR predicted the efficacy of first-line treatment for advanced gastric cancer best (AUC=0.746). Conclusion CTC and NLR are independent prognostic factors affecting PFS in patients with advanced gastric cancer, and CTC combined with NLR can better predict the efficacy of advanced gastric cancer.

Keywords

• circulating tumor cells
• neutrophil/lymphocyte ratio
• gastric cancer
• advanced
• firstline treatment
• rogression free survival