aot2022v55i2

Acta Oncologica Turcica 2022; 55: 116-127
123
Figure 3. Overall survival plot with regard to leakage
time between diagnosis and surgery
(p=0.263), total number of lymph nodes
(p=0.659), number of metastatic lymph nodes
(p=0.463), extracapsular invasion (p=0.305),
lymphovascular invasion (p=0.264), surgical
margin positivity (p=0.246), T stage
(p=0.130), TNM stage (p=0.448), infection
(p=0.456), recurrence (p=0.273), and
haemoglobin (p=0.651) were also found to be
non-significant.
Discussion
This study aimed to determine possible
relationships between preoperative NLR and
PLR levels and the clinical characteristics of
locally advanced GC, and to assess whether
they had predictive significance on disease
prognosis. Contrary to previous literature, we
did not obtain optimal cut-off values for PLR
and NLR to predict mortality, and we
demonstrated that preoperative NLR and PLR
were non-significant determinants for
prognosis in patients with locally advanced
GC. We showed that greater tumour size,
presence of perineural invasion, N3 stage,
leakage, and also lower albumin levels may be
poor prognostic predictors for mortality in
patients with locally-advanced GC.
Cancer-related inflammation has been
described as a substantial cross-talk factor
associated with neoplastic growth since it was
first suggested by Virchow in the 19th century
[10]. In the tumour microenvironment,
stromal cells around tumours recruit cytokineproducing
inflammatory cells which could
facilitate cancer progression in association
with proliferation, resistance to apoptosis,
induction of angiogenesis, evasion of growth
suppressors, development of replicate
immortality and activation of invasion and
metastasis [2]. Neutrophils may have a critical
role in cancer development and progression
through pro-angiogenic factors, inflammatory
mediators and matrix metalloproteinases [11].
Furthermore, increased neutrophil count in the
tumour microenvironment can suppress the
antitumor properties of activated T cells and
the cytolytic function of immune cells, while
also possibly limiting lymphoplasmacytic
reactions in tumour cells [12]. Lymphocytes
may exhibit a significant role as extrinsic
tumour suppressors by attacking and
eliminating tumour cells at the outset of
tumorigenesis [13]. Patients who have
decreased lymphocyte count may have
suppressed cell-mediated immune response
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