First day postoperative values of the neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, and C-reactive protein as complication predictors following gastric oncologic surgery

D Ortiz-López; M A Acosta-Mérida; J A Casimiro-Pérez; J Silvestre-Rodríguez; J Marchena-Gómez

doi:10.1016/j.rgmxen.2021.11.003

First day postoperative values of the neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, and C-reactive protein as complication predictors following gastric oncologic surgery

Rev Gastroenterol Mex (Engl Ed). 2022 Apr-Jun;87(2):142-148. doi: 10.1016/j.rgmxen.2021.11.003. Epub 2021 Nov 15.

Authors

D Ortiz-López¹, M A Acosta-Mérida², J A Casimiro-Pérez¹, J Silvestre-Rodríguez¹, J Marchena-Gómez¹

Affiliations

¹ Servicio de Cirugía General y del Aparato Digestivo, Hospital Universitario de Gran Canaria Doctor Negrín, Las Palmas de Gran Canaria, Las Palmas, Spain.
² Servicio de Cirugía General y del Aparato Digestivo, Hospital Universitario de Gran Canaria Doctor Negrín, Las Palmas de Gran Canaria, Las Palmas, Spain. Electronic address: maacosta03@yahoo.es.

PMID: 34794921
DOI: 10.1016/j.rgmxen.2021.11.003

Abstract

Introduction: The neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and C-reactive protein (CRP) level are simple laboratory test parameters that can provide us with information on the inflammatory status of the organism. CRP has been shown to be a predictor of postoperative complications, whereas NLR and PLR have shown greater usefulness in the prognosis of oncologic pathologies.

Aim: To evaluate the associations of NLR and PLR with postoperative complications following gastric oncologic surgery and compare them with CRP.

Materials and methods: A prospective study was conducted on 66 patients that underwent oncologic gastric surgery, within the time frame of January 2014 and March 2019. The variables analyzed were sociodemographic data, surgical technique, tumor extension, and NLR, PLR, and CRP levels from the first day after surgery, as well as postoperative complications.

Results: Seventeen patients (25.8%) presented with grade III-V complications, utilizing the Clavien-Dindo classification system. Mean NLR value was 11.30 and was associated with the appearance of major complications, with statistical significance (p = 0.009). Mean PLR was266.05 and was not significantly associated with complications (p = 0.149). Fifty-four patients had a mean CRP level of 143.24 and it was not related to the appearance of major complications (p = 0.164).

Conclusions: The NLR is a simple and inexpensive parameter, which measured on postoperative day one, predicted the appearance of major postoperative complications in our study sample and appears to be a better predictive parameter than CRP for said complications. Further studies to confirm that trend need to be carried out.

Keywords: C-reactive protein; Cirugía gástrica; Complicaciones postoperatorias; Gastric surgery; Neutrophil-to-lymphocyte ratio; Platelet-to-lymphocyte ratio; Postoperative complications; Proteína C Reactiva; Relación Neutrófilo Linfocito; Relación Plaqueta Linfocito.

MeSH terms

Blood Platelets / cytology
C-Reactive Protein / analysis
Digestive System Surgical Procedures* / adverse effects
Humans
Lymphocytes / cytology
Neutrophils / cytology
Postoperative Complications* / etiology
Prospective Studies
Retrospective Studies

Substances

C-Reactive Protein