Abstract: Objective To investigate the relationship between preoperative and postoperative changes of neutrophil-lymphocyte ratio（NLR）and prognosis of gastrointestinal stromal tumor（GIST）.Methods The clinical and pathological data of 228 patients with GIST were analyzed retrospectively.According to the changes of NLR before and after surgery,the patients were divided into two groups:NLR elevation group（n=124）and NLR reduction group（n=104）.The relationship between preoperative and postoperative NLR changes and clinicopathological features and disease-free survival of patients with GIST were analyzed. Results There were no significant differences in gender,age,tumor location,and adjuvant treatment with imatinib after surgery in the NLR elevation group and the NLR reduction group（P＞0.05）.The differences in risk,karyokinesis,Ki-67 proliferation index,and preoperative NLR were statistically significant（P＜0.05）.Univariate analysis suggested that the following factors directly affected the patient’s disease-free survival:tumor size,risk,Ki-67 proliferation index,preoperative NLR,preoperative and postoperative NLR changes.Cox multivariate risk regression showed that tumor size,risk,preoperative NLR,preoperative and preoperative NLR changes were independent factors affecting disease-free survival. Conclusions Preoperative and postoperative changes in NLR are independent factors affecting the prognosis of gastrointestinal stromal tumor,and it is expected to be an effective evaluation index for predicting the prognosis of gastrointestinal stromal tumor.