Surgery Today

, Volume 49, Issue 3, pp 206–213 | Cite as

Postoperative ratio of the maximum C-reactive protein level to the minimum peripheral lymphocyte count as a prognostic indicator for gastric cancer patients

  • Yusuke Kono
  • Hiroaki SaitoEmail author
  • Yuki Murakami
  • Yuji Shishido
  • Hirohiko Kuroda
  • Tomoyuki Matsunaga
  • Manabu Yamamoto
  • Yoji Fukumoto
  • Tomohiro Osaki
  • Keigo Ashida
  • Yoshiyuki Fujiwara
Original Article



Inflammation, together with immune and nutritional status, are associated with the progression of various cancer types. We evaluated the prognostic significance of the postoperative ratio (post-CLR) of the maximum C-reactive protein value (post-CRPMax) to the minimum peripheral lymphocyte count (post-LCMin) in patients with gastric cancer (GC).


The subjects of this retrospective study were 227 patients who underwent curative surgery for histopathologically diagnosed gastric adenocarcinoma.


The 5-year overall survival (OS) rates differed significantly between the post-CLRHigh (≥ 152.6) group and the post-CLRLow (< 152.6) group for all patients (45.0% vs. 68.4%, respectively; P < 0.001). The 5-year disease-specific survival (DSS) rates were also significantly related to post-CLR for all patients, (80.6% vs. 64.3% for the post-CLRLow and the post-CLRHigh groups, respectively; P = 0.002). Among patients without infectious complications, the CLR affected both the 5-year OS rate (48.4% vs. 69.2% for the post-CLRHigh and the post-CLRLow groups, respectively; P = 0.006) and the 5-year DSS rate (80.2% vs. 67.0% for the post-CLRLow and the post-CLRHigh groups, respectively; P = 0.027). Multivariate analysis revealed that post-CLR was an independent prognostic indicator for both the OS and DSS of all patients.


Our finding show that the post-CLR can help predict the prognosis of GC patients.


CRP Gastric cancer Lymphocyte Prognosis Recurrence 



We received no grants, equipment or funding for this study.

Compliance with ethical standards

Conflict of interest

We have no real or potential conflicts of interest to declare.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.


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Copyright information

© Springer Nature Singapore Pte Ltd. 2018

Authors and Affiliations

  • Yusuke Kono
    • 1
  • Hiroaki Saito
    • 1
    Email author
  • Yuki Murakami
    • 1
  • Yuji Shishido
    • 1
  • Hirohiko Kuroda
    • 1
  • Tomoyuki Matsunaga
    • 1
  • Manabu Yamamoto
    • 1
  • Yoji Fukumoto
    • 1
  • Tomohiro Osaki
    • 1
  • Keigo Ashida
    • 1
  • Yoshiyuki Fujiwara
    • 1
  1. 1.Division of Surgical Oncology, Department of Surgery, School of MedicineTottori University Faculty of MedicineYonagoJapan

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