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The Granulocyte-to-Lymphocyte Ratio as a Marker of Surgical Stress and a Predictor of Postoperative Infectious Complications After Gastric Cancer Surgery: An Analysis of Patients Enrolled in a Prospective Randomized Trial

  • Gastrointestinal Oncology
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

The granulocyte-to-lymphocyte ratio (GLR) in the blood may be a useful marker of surgical stress (SS) following surgery for cancer. The aim of the present study was to compare the SS by measuring the GLR, and further study the value of the GLR in predicting postoperative infectious complications (ICs).

Methods

Data from 201 gastric cancer patients at Fujian Medical University Union Hospital who were enrolled in our prospective randomized controlled trial were extracted for this study. Blood samples to perioperatively measure the GLR were routinely taken. Additional external validation was performed using the dataset (n = 135) from Nanfang Hospital who were enrolled in the same trial.

Results

Patients undergoing either laparoscopic or open resection showed a similar preoperative GLR, as well as similar GLRs, on postoperative days (PODs) 1 and 3. The GLR on POD 5 was lower in the laparoscopic group compared with the open group (p = 0.014), and the optimal predictive GLR thresholds of postoperative ICs in both the laparoscopic and open groups were the same on POD 5, i.e. 6.5 and 7.4, respectively. The GLR on POD 5 was identified as an independent factor for postoperative ICs in both the laparoscopic and open groups. Similar results were found in the validation dataset.

Conclusion

The GLR status not only correlates with SS but may also be a reliable predictor of ICs for gastric cancer patients after gastrectomy. The ideal GLR thresholds on POD 5 for ICs following laparoscopic and open gastrectomy are 6.5 and 7.4, respectively.

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Disclosure

Jun Lu, Hao Liu, Long-long Cao, Chao-hui Zheng, Ping Li, Jian-wei Xie, Jia-bin Wang, Jian-xian Lin, Qi-yue Chen, Mi Lin, Ru-hong Tu, Guo-xin Li, and Chang-ming Huang declare no conflict of interest in connection with the publication of this work.

Funding

This work was supported by the National Key Clinical Specialty Discipline Construction Program of China (No. [2012] 649), the Key Projects of Science and Technology Plan of Fujian Province (No. 2014Y0025), and the Fund of Fujian Province science and technology innovation talents. Scientific and technological innovation joint capital projects of Fujian Province (2016Y9031).

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Author notes

  1. Jun Lu and Hao Liu contributed equally to this work.

Authors and Affiliations

  1. Department of Gastric Surgery, Department of General Surgery, Fujian Medical University Union Hospital, Fuzhou, China

    Jun Lu MD, PhD, Long-long Cao MD, Chao-hui Zheng MD, PhD, Ping Li MD, PhD, Jian-wei Xie MD, PhD, Jia-bin Wang MD, PhD, Jian-xian Lin MD, PhD, Qi-yue Chen MD, Mi Lin MD, Ru-hong Tu MD & Chang-ming Huang MD, PhD

  2. Department of General Surgery, Nanfang Hospital, Southern Medical University, Guangzhou, China

    Hao Liu MD, PhD & Guo-xin Li MD, PhD

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  1. Jun Lu MD, PhD
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Correspondence to Guo-xin Li MD, PhD or Chang-ming Huang MD, PhD.

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Lu, J., Liu, H., Cao, Ll. et al. The Granulocyte-to-Lymphocyte Ratio as a Marker of Surgical Stress and a Predictor of Postoperative Infectious Complications After Gastric Cancer Surgery: An Analysis of Patients Enrolled in a Prospective Randomized Trial. Ann Surg Oncol 24, 2688–2697 (2017). https://doi.org/10.1245/s10434-017-5846-y

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  • DOI: https://doi.org/10.1245/s10434-017-5846-y

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