Miyata Hiroshi, Yamasaki Makoto, Kurokawa Yukinori, Takiguchi Shuji, Nakajima Kiyokazu, Fujiwara Yoshiyuki, Mori Masaki, Doki Yuichiro
Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, Osaka, Japan.
Exp Ther Med. 2011 Sep;2(5):879-885. doi: 10.3892/etm.2011.308. Epub 2011 Jun 30.
Recent studies have shown that the presence of systemic inflammation is associated with poor outcome in patients with malignancy. However, whether systemic inflammation affects the response to pre-operative therapy and survival of patients undergoing multimodal treatment for esophageal cancer is not clear. We studied 152 patients who underwent pre-operative chemotherapy followed by surgery for esophageal cancer. The correlation between various clinicopathological factors, including hematological markers of systemic inflammatory response, and survival or response to chemotherapy was examined. Among various hematological factors, leucocyte count, hemoglobin level, albumin level, neutrophil-lymphocyte ratio and CEA, but not serum concentration of C-reactive protein, were significantly associated with survival. Multivariate analysis revealed that the clinical response to chemotherapy, number of metastatic lymph nodes, operative complications and systemic inflammation score (SI score), comprising leucocyte count, albumin and hemoglobin levels, were independent prognostic factors, and identified the SI score as the most significant prognostic factor. There was no significant relationship between hematological markers of systemic inflammation, including the SI score, and the response to chemotherapy. In conclusion, in patients scheduled for chemotherapy followed by surgery for esophageal cancer, systemic inflammation, reflected by SI, predicts poor outcome, but not the response to chemotherapy.
近期研究表明，全身炎症的存在与恶性肿瘤患者的不良预后相关。然而，全身炎症是否会影响接受多模式治疗的食管癌患者对术前治疗的反应及生存情况尚不清楚。我们研究了152例接受术前化疗后行食管癌手术的患者。检测了包括全身炎症反应血液学指标在内的各种临床病理因素与生存或化疗反应之间的相关性。在各种血液学因素中，白细胞计数、血红蛋白水平、白蛋白水平、中性粒细胞与淋巴细胞比值及癌胚抗原，但不包括血清C反应蛋白浓度，均与生存显著相关。多因素分析显示，化疗的临床反应、转移淋巴结数量、手术并发症及全身炎症评分（SI评分，包括白细胞计数、白蛋白和血红蛋白水平）是独立的预后因素，并确定SI评分为最显著的预后因素。包括SI评分在内的全身炎症血液学指标与化疗反应之间无显著关系。总之，对于计划接受化疗后行食管癌手术的患者，SI所反映的全身炎症预示着不良预后，但不能预测化疗反应。
