A potential novel biomarker in predicting lymph node metastasis of gastric signet ring cell carcinoma: A derived monocyte to lymphocyte ratio

This study is designed to evaluate the predictive value of derived monocyte to lymphocyte ratio (dMLR), neutrophil to lymphocyte ratio (NLR) and eosinophil to lymphocyte ratio (ELR) for lymph node metastasis (LNM) in gastric signet ring cell carcinoma (SRCC) patients. We carried out a retrospective analysis for 203 eligible patients who underwent radical gastrectomy between January 2011 and September 2020. The diagnostic sensitivity and specificity for dMLR were 60.3% and 72.2%, respectively; while for NLR and ELR were 64.1% and 66.6%, and 91.6% and 23.6%, respectively. The dMLR and NLR were identified as independent predictors of LNM, but ELR was not. A nomogram was developed incorporating dMLR and clinical characteristics with AUC of 0.868, and the outcome of DCA supported good clinical benefit. dMLR is a promising novel preoperative biomarker to predict LNM of gastric SRCC. •The derived monocyte to lymphocyte ratio (dMLR) can independently predict LNM in gastric SRCC patients.•A nomogram was developed for individual risk assessment incorporating dMLR and clinical characteristics.•dMLR is a promising biomarker to estimate the risk of LNM in clinical practice which is reliable and cost-effective.