Evaluations of interferon-γ/interleukin-4 ratio and neutrophil/lymphocyte ratio as prognostic indicators in gastric cancer patients

J Surg Oncol. 2010 Dec 1;102(7):742-7. doi: 10.1002/jso.21725.


Background and objectives: Th2-dominant immunity and high neutrophil/lymphocyte ratios (NLRs) have been reported to reflect tumor progression, and so we examined whether the Th1/Th2 ratio and NLR can act as prognostic indicators or not.

Methods: Peripheral blood samples were taken within 1 week before and 14 postoperative days after curative gastrectomy using 157 gastric cancer cases for the measurement of both ratios. The proportions of Th1 cells (interferon γ-producing CD4 T cells), Th2 cells (interleukin-4-producing CD4 T cells) were counted by two-color flow cytometry analysis.

Results: There were significant differences in 5-year survival both between the high and low Th1/Th2 ratio groups, and between the high and low NLR groups. The pattern classifications before and after surgery in the Th1/Th2 ratio showed strongly significant differences in 5-year survival. NLR was especially influenced by tumor size, and there was a negative linear correlation between the two ratios before surgery.

Conclusions: The Th1/Th2 ratio may be a good prognostic indicator and may also be a promising marker for estimating the effectiveness of surgery. NLR may also be a good prognostic indicator and may be a valid marker of tumor recurrence, and it appeared that some interaction between lymphocytes and neutrophils had occurred.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Female
  • Flow Cytometry
  • Humans
  • Interferon-gamma / blood*
  • Interleukin-4 / blood*
  • Intestinal Neoplasms / blood*
  • Intestinal Neoplasms / immunology
  • Intestinal Neoplasms / pathology
  • Lymphatic Metastasis
  • Lymphocyte Count
  • Lymphocytes / pathology*
  • Male
  • Middle Aged
  • Neoplasm Staging
  • Neutrophils / pathology*
  • Prognosis
  • Retrospective Studies
  • Stomach Neoplasms / blood*
  • Stomach Neoplasms / immunology
  • Stomach Neoplasms / pathology
  • Survival Rate
  • Th1 Cells / immunology
  • Th2 Cells / immunology


  • Interleukin-4
  • Interferon-gamma