Significance of preoperative evaluations of tumor necrosis factor-alpha, the granulocyte/lymphocyte ratio and their correlation with regard to outcome in gastric cancer patients.

AIM: In order to clarify the anti-cancer effects of tumor necrosis factor-alpha (TNFalpha), we examined the relationship between the preoperative evaluations of TNFalpha and the granulocyte/lymphocyte ratio (G/L ratio) in relation to outcome in gastric cancer patients. MATERIALS AND METHODS: Peripheral blood samples were taken within 1 week before curative gastrectomy for measurement of TNFalpha and the G/L ratio. Five-year survival was determined in 71 operative gastric cancer cases. RESULTS: The 5-year survival of the high TNFalpha group (> or =8,000 pg/ml ) was 64.1%, 29.0% for the low TNFalpha group (<8,000 pg/ml) and 13.3 and 73.1% for those of the high (> or =4.0) and low (<4.0) G/L ratio groups, respectively. The comparisons of these 5-year survival rates showed statistically significant differences. Moreover, there was a negative linear correlation between TNFalpha and the G/L ratio regarding outcome. CONCLUSIONS: Preoperative evaluations with TNFalpha and the G/L ratio may be important prognostic indicators, and their correlation may be a good indicator of the degree of effectiveness in activating anti-cancer immunity in gastric cancer patients.