To evaluate the value of preoperative platelet-to-lymphocyte ratio (PLR) combined with CA19-9 in evaluating postoperative prognosis of patients with gallbladder cancer.

Clinical data of 67 patients with gallbladder cancer admitted to Tongji Hospital Affiliated to Tongji Medical College of Huazhong University of Science and Technology from December 2015 to December 2020 were retrospectively analyzed. Among them, 28 patients were male and 39 female, aged (58±10) years on average. The informed consents of all patients were obtained and the local ethical committee approval was received. Survival analysis was performed by Kaplan-Meier method and Log-rank test. The independent risk factors of postoperative prognosis of patients with gallbladder cancer were identified by multivariate Cox regression analysis. The efficiency of PLR + CA19-9 for predicting postoperative prognosis of patients with gallbladder cancer was assessed by delineating the area under ROC curve (AUC).

ROC curve analysis showed that the optimal thresholds of PLR, CA19-9 and PLR + CA19-9 for predicting 3-year overall survival (OS) of patients with gallbladder cancer were 162, 38 and 0.65, respectively. Multivariate Cox regression analysis indicated that PLR≥162 and CA19-9≥38 kU/L were the independent risk factors for postoperative prognosis of patients with gallbladder cancer (HR=3.093, 3.852; P<0.05). The median OS in the low and high PLR + CA19-9 groups was 43 and 15 months, and the difference was statistically significant (χ²=44.342, P<0.05). The AUC of PLR in predicting postoperative 1- and 3-year progression-free survival of patients with gallbladder cancer was 0.741 and 0.777, 0.838 and 0.780 for CA19-9, and 0.901 and 0.882 for PLR + CA19-9, respectively.

Preoperative PLR combined with CA19-9 has higher value in predicting postoperative prognosis of patients with gallbladder cancer compared with PLR or CA19-9alone, which is of certain value in clinical application.