Platelet to lymphocyte ratio as a novel prognostic tool for gallbladder carcinoma

Table 1 Basic characteristics of gallbladder carcinoma patients stratified according to serum level of platelet to lymphocyte ratio

Variable	Overall(n = 316)	PLR < 117.7(n = 100)	PLR≥117.7(n = 216)	P value
Age (yr)	65 (30-87)	65 (43-87)	64 (30-87)	0.1551
Men/Women	101/215	39/61	62/154	0.0681
Gallstone/No	160/156	50/50	110/106	0.8781
Diabetes/No	30/286	10/90	20/196	0.8351
Hypertension/No	57/259	19/81	38/178	0.7621
PLT (109/L)	184 (37-525)	139 (37-261)	216 (37-525)	< 0.0012
Lymphocytes (109/L)	1.3 (0.3-3.5)	1.6 (0.4-3.5)	1.1 (0.2-2.9)	< 0.0012
PLR	152.4 (13.8-2282.6)	93.6 (13.8-117.6)	185.5 (117.9-2282.6)	< 0.0012
WBC (109/L)	6.2 (1.6-33.4)	5.6 (1.9-33.4)	6.6 (1.6-23.4)	0.0132
Neutrophils (109/L)	4.2 (1.0-25.9)	3.4 (1.0-25.9)	4.6 (1.0-19.3)	< 0.0012
CEA (ng/mL)	3.6 (0.5-264.8)	3.8 (1.0-90.6)	3.6 (0.5-264.8)	0.8472
	(n = 168)	(n = 44)	(n = 124)
AFP (ng/mL)	2.9 (1.1-615.4)	3.0 (1.1-53.0)	2.8 (1.1-615.4)	0.7632
	(n = 150)	(n = 36)	(n = 114)
CA-125 (U/mL)	30.8 (6.1-3684)	21.0 (6.1-345.6)	36.5 (6.5-3684.0)	0.0042
	(n = 146)	(n = 41)	(n = 105)
CA-199 (U/mL)	100.5 (0.5-10000)	99.6 (0.5-4306)	125.0 (0.5-10001)	0.3842
	(n = 158)	(n = 45)	(n = 113)
TNM stage I/II/III/IVA/IVB	5/24/59/121/107	4/12/21/36/27	1/12/38/85/80	0.0191
Differentiation:	26/134/156	13/48/39	13/86/117	0.0311
high/moderate/low
Survival time (mo)	9 (1-97)	12 (1-77)	8 (1-97)	< 0.0012
Death/No	254/62	71/29	183/33	0.0041

¹χ² test;

²Wilcoxon test. The values are expressed as the median (range) or number. PLR: Platelet to lymphocyte ratio; PLT: Platelet count; WBC: White blood cell count; CEA: Carcinoembryonic antigen; AFP: Alpha-fetoprotein.

Table 2 Spearman’s correlation analysis between platelet to lymphocyte ratio and clinical characteristics of gallbladder carcinoma patients

Variable	Coefficient	P value
Age (yr)	-0.017	0.758
Gender	0.030	0.600
PLT (109/L)	0.568	< 0.001
Lymphocytes (109/L)	-0.587	< 0.001
Neutrophils (109/L)	0.356	< 0.001
WBC (109/L)	0.207	< 0.001
CEA (ng/mL)	0.032	0.678
AFP (ng/mL)	-0.073	0.375
CA-125 (U/mL)	0.262	0.001
CA-199 (U/mL)	0.133	0.096
TNM stage	0.104	0.064
Differentiation	0.181	0.001
Survival time (mo)	-0.237	< 0.001

Table 3 Univariate analysis of factors associated with overall survival of gallbladder carcinoma patients

As binary data			As quantitative/ordinal data
Variable	P value	HR (95%CI)	Variable	P value	HR (95%CI)
Age > 60 yr	0.574	1.078 (0.829-1.403)	Age (per 1 yr increase)	0.456	1.004 (0.993-1.016)
Women vs men	0.829	1.030 (0.788-1.345)
Gallstone (yes vs no)	0.309	1.137 (0.887-1.458)
Diabetes (yes vs no)	0.420	1.194 (0.777-1.835)
Hypertension (yes vs no)	0.997	1.001 (0.725-1.382)
CEA > 3.4 ng/mL	0.012	1.620 (1.114-2.355)	CEA (per 1 ng/mL increase)	0.071	1.005 (1.000-1.011)
AFP > 20 ng/mL	0.420	0.663 (0.244-1.801)	AFP (per 1 ng/mL increase)	0.296	0.997 (0.990-1.003)
CA-125 > 35.0 U/mL	0.002	1.813 (1.236-2.658)	CA-125 (per 10 U/mL increase)	0.027	1.005 (1.001-1.009)
CA-199 > 39.0 U/mL	0.002	1.930 (1.284-2.903)	CA-199 (per 10 U/mL increase)	0.028	1.001 (1.000-1.002)
PLT > 300 × 109/L	0.956	1.013 (0.647-1.594)	PLT (per 109/L increase)	0.053	1.001 (1.000-1.003)
Lymphocytes	0.243	1.173 (0.897-1.534)	Lymphocytes (per 109/L increase)	0.064	0.801 (0.633-1.013)
< 1.5 × 109/L
PLR ≥ 117.7	< 0.001	1.644 (1.246-2.169)	PLR (per 10 increase)	0.023	1.007 (1.001-1.013)
TNM IV vs I-III	< 0.001	1.692 (1.260-2.274)	TNM (per 1 stage increase)	< 0.001	1.377 (1.213-1.564)
Differentiation (low vs moderate/high)	< 0.001	1.563 (1.217-2.006)	Differentiation (per 1 grade increase)	< 0.001	1.523 (1.256-1.845)

HR: Hazard ratio; CI: Confidence interval.