Evaluations of Interferon-γ/Interleukin-4 Ratio and Neutrophil/Lymphocyte Ratio as Prognostic Indicators in Gastric Cancer Patients

Background and Objectives: Th2-dominant immunity and high neutrophil/lymphocyte ratios (NLRs) have been reported to reflect tumor progression, and so we examined whether the Th1/Th2 ratio and NLR can act as prognostic indicators or not. Methods: Peripheral blood samples were taken within 1 week before and 14 postoperative days after curative gastrectomy using 157 gastric cancer cases for the measurement of both ratios. The proportions of Th1 cells (interferon gamma-producing CD4 T cells), Th2 cells (interleukin-4-producing CD4 T cells) were counted by two-color flow cytometry analysis. Results: There were significant differences in 5-year survival both between the high and low Th1/Th2 ratio groups, and between the high and low NLR groups. The pattern classifications before and after surgery in the Th1/Th2 ratio showed strongly significant differences in 5-year survival. NLR was especially influenced by tumor size, and there was a negative linear correlation between the two ratios before surgery. Conclusions: The Th1/Th2 ratio may be a good prognostic indicator and may also be a promising marker for estimating the effectiveness of surgery. NLR may also be a good prognostic indicator and may be a valid marker of tumor recurrence, and it appeared that some interaction between lymphocytes and neutrophils had occurred. J. Surg. Oncol. 2010:102:742-747. (C) 2010 Wiley-Liss, Inc.