ニワ　ユキコ   Yukiko Niwa   丹羽　由紀子    所属   医学部 医学科（附属八千代医療センター）    職種   講師
論文種別	原著
言語種別	英語
査読の有無	査読あり
表題	Clinical utility of the platelet-lymphocyte ratio as a predictor of postoperative complications after radical gastrectomy for clinical T2-4 gastric cancer.
掲載誌名	正式名：World journal of gastroenterology 略　 称：World J Gastroenterol ISSNコード：22192840/10079327
掲載区分	国外
巻・号・頁	23(14),pp.2519-2526
著者・共著者	Inaoka Kenichi, Kanda Mitsuro, Uda Hiroaki, Tanaka Yuri, Tanaka Chie, Kobayashi Daisuke, Takami Hideki, Iwata Naoki, Hayashi Masamichi, Niwa Yukiko, Yamada Suguru, Fujii Tsutomu, Sugimoto Hiroyuki, Murotani Kenta, Fujiwara Michitaka, Kodera Yasuhiro
発行年月	2017/04
概要	AIM:To identify simple and sensitive markers for postoperative complications after gastrectomy, the predictive values were compared among candidate preoperative factors.METHODS:Three-hundred and twelve patients with previously untreated clinical T2-4 gastric cancer who underwent a D2 standard gastrectomy (distal gastrectomy or total gastrectomy) were included in the analysis. Correlations between 21 parameters that can be determined by preoperative routine blood tests and clinically relevant postoperative complications (grade II or higher according to the Clavien-Dindo classification) were evaluated. The optimal cutoff values and clinical significance of the selected markers were further evaluated by subgroup analyses according to age, body mass index, operative procedure and clinical disease stage.RESULTS:Sixty-six patients (21.1%) experienced grade II or higher postoperative complications. The platelet-lymphocyte ratio (PLR, total lymphocyte count/platelet count × 100) exhibited the highest area under the curve value (0.639) for predicting postoperative complications among the 21 parameters, and the optimal cutoff value was determined to be 0.71 (sensitivity = 70%, specificity = 56%). In the univariate analysis, the odds ratio of a low PLR for the occurrence of postoperative complications was 2.94 (95%CI: 1.66-5.35, P < 0.001), and a multivariate binomial logistic analysis involving other potential risk factors identified a low PLR as an independent risk factor for postoperative complications (OR = 3.32, 95%CI: 1.82-6.25, P < 0.001). In subgroups classified according to age, body mass index, operative procedure and clinical disease stage, the low PLR group exhibited an increased incidence of postoperative complications.CONCLUSION:The preoperative PLR is a simple and useful predictor of complications after curative gastrectomy in patients with clinical T2-4 gastric cancer.
DOI	10.3748/wjg.v23.i14.2519
PMID	28465636