Evaluating Preoperative Neutrophil/Lymphocyte and Platelet/Lymphocyte Ratios as Predictors of Lymph Node Metastasis in Gastric Cancer

Objective: Both NLR and PLR have gained attention as markers of systemic inflammation and are increasingly being investigated for their potential to predict cancer prognosis. Elevated NLR and PLR values have been associated with poorer outcomes in various malignancies, making their evaluation critical in assessing the metastatic potential in gastric cancer patients. This study aims to evaluate the relationship between lymph node metastasis in gastric cancer and preoperative neutrophil/lymphocyte ratio (NLR) and platelet/lymphocyte ratio (PLR). Material and Method: Between January 2013 and December 2019, a total of 296 patients diagnosed with gastric adenocarcinoma were identified and underwent surgery at the General Surgery Clinic of Haydarpaşa Numune Training and Research Hospital. Patients who received palliative surgery or preoperative blood transfusions were excluded, resulting in a study cohort of 247 patients who underwent curative surgery. The study was conducted with the approval of the Ethics Committee of Haydarpaşa Numune Training and Research Hospital (Document No. 771/12/2019). Results: The study found no statistically significant relationship between lymphocyte (p=0.546), NLR (p=0.094), and PLR (p=0.142) values and the extent of gastric wall invasion (T) (p>0.05). However, significant correlations were observed between platelet (p=0.016) and neutrophil (p=0.009) counts and T stage (p<0.05). Among patients with lymph node metastasis, positive correlations were identified between the number of metastatic lymph nodes and both NLR (r=0.166) and PLR (r=0.197) values (p<0.05). Conclusion: This retrospective analysis suggests that while NLR and PLR values do correlate with lymph node metastasis, they are not reliable standalone predictive markers for preoperative identification of lymph node metastasis in gastric cancer. These findings underscore the necessity for further research into more refined inflammatory markers or composite indices that could better predict lymph node involvement in gastric cancer.