Feng Ji-Feng, Liu Jin-Shi, Huang Ying
From the Department of Thoracic Surgery (JFF, JSL) and Department of Operating Theatre (YH), Zhejiang Cancer Hospital, Hangzhou, China.
Medicine (Baltimore). 2014 Dec;93(27):e257. doi: 10.1097/MD.0000000000000257.
Lymphopenia is a useful predictive factor in several cancers. The aim of this study was to determine the prognostic value of lymphopenia in patients with esophageal squamous cell carcinoma (ESCC).A retrospective analysis of 307 consecutive patients who had undergone esophagectomy for ESCC was conducted. In our study, a lymphocyte count (LC) of fewer than 1.0 Giga/L was defined as lymphopenia. Kaplan-Meier method was used to calculate the cancer-specific survival (CSS). Cox regression analyses were performed to evaluate the prognostic factors. Receiver operating characteristic (ROC) curve was also plotted to verify the accuracy of LC for CSS prediction.The mean LC was 1.55 ± 0.64 Giga/L (range 0.4-3.7 Giga/L). The incidence of lymphopenia (LC < 1.0 Giga/L) was 16.6% (51/307). Patients with lymphopenia (LC < 1.0 Giga/L) had a significantly shorter 5-year CSS (21.6% vs 43.8%, P = 0.004). On multivariate analysis, lymphopenia (LC < 1.0 Giga/L) was an independent prognostic factor in patients with ESCC (P = 0.013). Lymphopenia had a hazard ratio (HR) of 1.579 [95% confidence interval (CI): 1.100-2.265] for CSS. ROC curve demonstrated that lymphopenia (LC < 1.0 Giga/L) predicts survival with a sensitivity of 86.2% and a specificity of 27.2%. Lymphopenia (LC < 1.0 Giga/L) is still an independent predictive factor for long-term survival in patients with ESCC.
淋巴细胞减少在多种癌症中是一个有用的预测因素。本研究的目的是确定淋巴细胞减少在食管鳞状细胞癌（ESCC）患者中的预后价值。对307例连续接受ESCC食管切除术的患者进行了回顾性分析。在我们的研究中，淋巴细胞计数（LC）少于1.0千兆/升被定义为淋巴细胞减少。采用Kaplan-Meier法计算癌症特异性生存率（CSS）。进行Cox回归分析以评估预后因素。还绘制了受试者工作特征（ROC）曲线以验证LC对CSS预测的准确性。平均LC为1.55±0.64千兆/升（范围0.4 - 3.7千兆/升）。淋巴细胞减少（LC < 1.0千兆/升）的发生率为16.6%（51/307）。淋巴细胞减少（LC < 1.0千兆/升）的患者5年CSS显著缩短（21.6%对43.8%，P = 0.004）。多因素分析显示，淋巴细胞减少（LC < 1.0千兆/升）是ESCC患者的独立预后因素（P = 0.013）。淋巴细胞减少对CSS的风险比（HR）为1.579 [95%置信区间（CI）：1.100 - 2.265]。ROC曲线表明，淋巴细胞减少（LC < 1.0千兆/升）预测生存的敏感性为86.2%，特异性为27.2%。淋巴细胞减少（LC < 1.0千兆/升）仍然是ESCC患者长期生存的独立预测因素。
