Neutrophil-Lymphocyte Ratio is a Predictor of Venous Thromboembolism in Gastric Cancer Patients

Background: The neutrophil-lymphocyte ratio (NLR) reflects inflammatory status. An elevated NLR has been reported to be a prognostic indicator in some malignant tumors. The aim of this study was to determine whether NLR at the time of venous thromboembolism (VTE) diagnosis is a prognostic factor for the response to anticoagulation and survival in gastric cancer patients treated with anticoagulation for VTE. Methods: We retrospectively enrolled 73 gastric cancer patients newly diagnosed with VTE, from among 597 patients pathologically confirmed for gastric cancer between January 2008 and December 2013. Univariate and multivariate analyses were performed to identify clinicopathological predictors in respect to the response to anticoagulation and overall survival. Results: Compared with the low NLR group, patients with high NLR presented more frequently with advanced tumor stage (p = 0.046) and deeper tumor depth (p = 0.033). Patients with poor histology differentiation (p = 0.045), high NLR (p = 0.001), and low albumin (p = 0.016) were statistically correlated with the poor response to anticoagulation. Multivariate analysis revealed that a high level of NLR (hazard ratio, 1.56, 95% CI: 1.32 - 1.87, p = 0.032) and advance cancer stage (hazard ratio, 2.11, 95% CI: 1.29 - 3.44, p = 0.043) were independent poor prognostic factors for OS in gastric cancer patients with VTE. Conclusions: The results demonstrated that the NLR at the time of VTE diagnosis could be a useful biomarker for predicting the response to anticoagulation and survival in gastric cancer patients with VTE.