Nomogram based on tumor-associated neutrophil-to-lymphocyte ratio to predict survival of patients with gastric neuroendocrine neoplasms

Table 1 Characteristics of the 142 patients with gastric neuroendocrine neoplasms with different tumor-associated neutrophil-to-lymphocyte ratios

Clinicopathological feature	TA-NLR		Univariate analysis	Multivariate analysis
	≤ 0.21 (n = 71)	> 0.21 (n = 71)	P value	P value
Age (yr)			0.322
≤ 70	57	52
> 70	14	19
Gender			0.851
Male	52	51
Female	19	20
Tumor site			0.099
Upper	39	26
Middle	10	15
Lower	17	18
Mixed	5	12
Tumor size (cm)			0.593
≤ 3.5	25	22
> 3.5	46	49
Ki-67 index (%)			0.081
≤ 2	13	6
≥ 3, ≤ 20	8	16
>20	50	49
Depth of invasion			0.044	0.406
T1	14	8
T2	7	3
T3	34	29
T4	16	31
Lymph node ratio			0.043	0.355
0	25	13
> 0, ≤ 0.2	25	24
> 0.2, ≤ 0.4	15	18
> 0.4	6	16
Lymphovascular invasion			0.610
No	43	40
Yes	28	31
ASA status			0.805
1 + 2	61	62
3 + 4	10	9
Postoperative complication			0.041	0.071
No	57	46
Yes	14	25
Surgical approach			0.855
Endo/laparoscopic	49	50
Open	22	21

TA-NLR: Tumor-associated neutrophil-to-lymphocyte ratio.

Table 2 Characteristics of 142 patients with gastric neuroendocrine neoplasms with different levels of tumor-associated neutrophil-to-lymphocyte ratios

Patient feature	TA-NLR		Univariate analysis
	≤ 0.21(n = 71)	> 0.21(n = 71)	P value
Symptom
Abdominal pain	46	41	0.390
Dysphagia	14	12	0.665
Nausea	12	9	0.480
Vomiting	5	5	1.000
Acid-reflux	9	4	0.156
Anemia	10	13	0.495
Abdominal distention	6	8	0.575
Gastrointestinal blood loss	12	14	0.665
Weight loss	24	29	0.386
No symptoms	2	7	0.105
Medical history
Hypertension	19	15	0.432
Diabetes	7	3	0.202
Coronary heart disease	4	4	1.000
Chronic gastritis	44	38	0.796
Family history	5	6	0.754
Smoking	26	27	0.862
Drinking	6	4	0.515

TA-NLR: Tumor-associated neutrophil-to-lymphocyte ratio.

Table 3 Variables associated with recurrence-free survival according to the Cox proportional hazards regression model

Variable	Univariate analysis			Multivariate analysis
	Hazard ratio	95%CI	P value	Hazard ratio	95%CI	P value
Age (yr)			0.790
≤ 70	Reference
> 70	1.083	0.602-1.950
Gender			0.126
Male	Reference
Female	0.608	0.322-1.149
Tumor site			0.770
Upper	Reference
Middle	0.825	0.389-1.751
Lower	0.885	0.465-1.682
Mixed	1.348	0.588-3.091
Tumor size (cm)			0.004			0.671
≤ 3.5	Reference			Reference
> 3.5	2.740	1.385-5.421		NA	NA
Lymphovascular invasion			0.144
No	Reference
Yes	1.471	0.876-2.468
ASA status			0.190
1 + 2	Reference
3 + 4	1.551	0.804-2.993
Postoperative complication			0.029
No	Reference			Reference		0.305
Yes	1.869	1.065-3.278		NA	NA
Surgical approach			0.249
Endo/laparoscopic	Reference
Open	0.733	0.432-1.243
Depth of invasion			0.005			0.557
T1	Reference			Reference
T2	5.328	0.483-58.789		NA	NA
T3	11.722	1.587-86.603		NA	NA
T4	19.301	2.629141.682		NA	NA
Lymph node ratio			< 0.001			< 0.001
0	Reference			Reference
> 0, ≤ 0.2	5.490	1.623-18.568		3.338	0.962-11.581
> 0.2, ≤ 0.4	8.091	2.393-27.351		4.6	1.317-16.066
> 0.4	17.946	5.239-61.480		10.266	2.906-36.266
Ki-67 index (%)			0.004			< 0.001
≤ 2	Reference			Reference
≥ 3, ≤ 20	3.013	0.639-14.203		1.501	0.305-7.393
> 20	7.047	1.709-29.053		4.999	1.140-21.927
TA-NLR			< 0.001			< 0.001
≤ 0.21	Reference			Reference
> 0.21	3.366	1.890-5.992		2.974	1.630-5.426

TA-NLR: Tumor-associated neutrophil-to-lymphocyte ratio.

Table 4 Variables associated with overall survival according to the Cox proportional hazards regression model

Variable	Univariate analysis			Multivariate analysis
	Hazard ratio	95%CI	P value	Hazard ratio	95%CI	P value
Age (yr)			0.566
≤ 70	Reference
> 70	1.197	0.648- 2.211
Gender			0.190
Male	Reference
Female	0.640	0.329-1.247
Tumor site			0.190
Upper	Reference
Middle	0.687	0.313-1.509
Lower	0.540	0.255-1.145
Mixed	1.441	0.628-3.307
Tumor size (cm)			0.002			0.214
≤ 3.5	Reference			Reference
> 3.5	3.591	1.618-7.969		NA	NA
Lymphovascular invasion			0.214
No	Reference
Yes	1.417	0.818-2.455
ASA status			0.118
1 + 2	Reference
3 + 4	1.736	0.870-3.465
Postoperative complication			0.320
No	Reference
Yes	1.380	0.732-2.603
Surgical approach			0.276
Endo/laparoscopic	Reference
Open	0.736	0.425-1.276
Depth of invasion			0.024			0.646
T1	Reference			Reference
T2	5.524	0.501-60.954		NA	NA
T3	10.793	1.455-80.038		NA	NA
T4	15.632	2.116-115.464		NA	NA
Lymph node ratio			< 0.001			0.002
0	Reference			Reference
> 0, ≤ 0.2	4.791	1.402-16.370		2.854	0.813-10.027
> 0.2, ≤ 0.4	6.676	1.956-22.790		3.724	1.054-13.162
> 0.4	14.677	4.218-51.074		9.152	2.528-33.129
Ki-67 index (%)			0.002			< 0.001
≤ 2%	Reference			Reference
≥ 3%, ≤ 20%	2.168	0.437-10.751		1.584	0.313-8.008
> 20%	6.582	1.589-27.269		5.535	1.238-24.752
TA-NLR			< 0.001			0.003
≤ 0.21	Reference			Reference
> 0.21	2.938	1.610-5.360		2.617	1.389-4.928

TA-NLR: Tumor-associated neutrophil-to-lymphocyte ratio.

Table 5 Site of recurrence after surgery

Site of recurrence	TA-NLR
	≤ 0.21(n = 71)	> 0.21(n = 71)	P value
Liver	10	28	0.001
Peritoneal cavity	6	9	0.413
Lymph node	2	11	0.009
Lung	3	4	0.721
Bone	0	5	0.058
Adrenal gland	1	4	0.366
Pancreas	2	2	1.000
Locoregional recurrence	2	3	0.683
Spleen	0	2	0.496
Kidney	1	1	1.000
Brain	0	1	1.000
Number of patients with recurrence	15	38	< 0.001

TA-NLR: Tumor-associated neutrophil-to-lymphocyte ratio.