The Ratio of the Hemoglobin to Red Cell Distribution Width Combined with the Ratio of Platelets to Lymphocytes Can Predict the Survival of Patients with Gastric Cancer Liver Metastasis

Abstract

Background. Hemoglobin/red cell distribution width (HR) and platelet/lymphocyte (PLR) ratios are considered effective prognostic markers in various cancers. We have proposed a new prognostic parameter: HR+PLR. The aim of this study is to explore the prognostic value of the HR+PLR scoring system in patients with gastric cancer liver metastasis. Methods. This study retrospectively analyzed the clinical data of 306 patients with gastric cancer liver metastases admitted to our hospital from 2007 to 2014. According to the size of HR value and PLR value, we will divide the patients into three groups, namely, HR+PLR: (1) 0 points: $\text{HR}>1.02$ and $\text{PLR}<128$ ; (2) 1 point: $\text{HR}>1.02$ and $\text{PLR}>128$ and $\text{HR}<1.02$ and $\text{PLR}<128$ ; and (3) 2 points: $\text{HR}<1.02$ and $\text{PLR}>128$ . Results. The HR+PLR score was statistically different from age ( $P=0.049$ ), T stage ( $P<0.001$ ), N stage ( $P=0.017$ ), number of liver metastases ( $P=0.018$ ), gastrectomy ( $P<0.001$ ), hepatectomy ( $P=0.001$ ), peritoneal metastasis ( $P=0.012$ ), prognostic nutritional index (PNI) ( $P=0.028$ ), and neutrophil/lymphocyte ratio (NLR) ( $P=0.045$ ). The HR+PLR scoring system has a higher area under the ROC curve (AUC value) than PNI, PLR, HR, and PLR ( $\text{AUC}=0.798$ , $P<0.001$ ). In multivariate analysis, gastrectomy ( $P=0.001$ ), hepatectomy ( $P<0.001$ ), chemotherapy ( $P=0.014$ ), and HR+PLR score ( $P<0.001$ ) were considered independent prognostic factors. Conclusion. For patients with gastric cancer liver metastasis, the HR+PLR score is a simple, reliable, and economic prognostic marker.