RÉSUMÉ
Objective:The prognosis of cancer patients depends not only on tumor related factors, but also on host related factors, especially systemic inflammatory response. Based on the ratio of neutrophils to lymphocytes (NLR), the ratio of platelets to lymphocytes (PLR) and the ratio of lymphocytes to monocytes (LMR), we constructed a systemic inflammation model to predict the survival time of patients with gastric cancer (GC) after radical gastrectomy.Methods:Two hundred and five patients with GC who underwent radical resection from January 2011 to January 2017 were selected in Qinghai Provincial Communications Hospital and Red Cross Hospital of Qinghai Province. NLR, PLR and LMR were collected before operation. The best truncation values of NLR, PLR and LMR were obtained by ROC curve and systemic inflammatory marker score (SIMS) was constructed. The clinical value of SIMS was analyzed by single factor and multi factor Cox risk proportion model.Results:All patients were followed up for an average of (63.47 ± 10.36) months (range 20 to 65 months). The median survival time was 56 months. The one-year mortality rate was 6.3%, the three-year mortality rate was 26.2%, and the five-year mortality rate was 34.6%. The AUC of NLR, PLR and LMR were 0.745, 0.805 and 0.866 respectively, and the best truncation values were 3.11, 144 and 3.34 respectively. The mortality of patients with NLR > 3.11, PLR > 144, LMR ≤ 3.34 was higher than that of patients with NLR ≤ 3.11, PLR ≤ 114, LMR > 3.34 ( χ2 = 10.491, 14.658 and 38.765; P<0.01); there were differences in survival curves among different groups of NLR, PLR, LMR ( P < 0.05). The survival curves of different scores of SIMS were different ( P < 0.05). Age ( HR = 1.358, 95% CI 1.153 to 1.599), T stage-T 3 ( HR = 2.739, 95% CI 1.200 to 6.248), T stage-T 4 ( HR = 3.013, 95% CI 1.312 to 6.920), N stage-N 2 ( HR = 5.832, 95% CI 2.974 to 11.455), pathological stage Ⅲ ( HR = 2.962, 95% CI 1.835 to 4.646), lymphovascular invasion ( HR = 1.813, 95% CI 1.274 to 3.642), SIMS-1 ( HR = 7.065, 95% CI 4.673 to 10.692), SIMS-2 ( HR = 7.885, 95% CI 4.991 to 12.435), SIMS-3 ( HR = 8.365, 95% CI 5.635 to 3.485) were the independent risk factors of GC patients′ death ( P < 0.05). Conclusions:This study successfully constructs Sims and confirms that preoperative Sims is a relatively easy, easy to obtain and low-cost prognosis index for GC patients, which can be used to evaluate the survival time of GC patients before operation.