Han Li-Hui, Jia Yi-Bin, Song Qing-Xu, Wang Jian-Bo, Wang Na-Na, Cheng Yu-Feng
Department of Radiation Oncology, Qilu Hospital of Shandong University, Jinan, China E-mail :
Asian Pac J Cancer Prev. 2015;16(6):2245-50. doi: 10.7314/apjcp.2015.16.6.2245.
The interaction between tumor cells and inflammatory cells has not been systematically investigated in esophageal squamous cell carcinoma (ESCC). The aim of the present study was to evaluate whether preoperative the lymphocyte-monocyte ratio (LMR), the neutrophil-lymphocyte ratio (NLR), and the platelet-lymphocyte ratio (PLR) could predict the prognosis of ESCC patients undergoing esophagectomy.
Records from 218 patients with histologically diagnosed ESCC who underwent attempted curative surgery from January 2007 to December 2008 were retrospectively reviewed. Besides clinicopathological prognostic factors, we evaluated the prognostic value of the LMR, the NLR, and the PLR using Kaplan-Meier curves and Cox regression models.
The median follow-up was 38.6 months (range 3-71 months). The cut-off values of 2.57 for the LMR, 2.60 for the NLR and 244 for the PLR were chosen as optimal to discriminate between survival and death by applying receiver operating curve (ROC) analysis. Kaplan-Meier survival analysis of patients with low preoperative LMR demonstrated a significant worse prognosis for DFS (p=0.004) and OS (p=0.002) than those with high preoperative LMR. The high NLR cohort had lower DFS (p=0.004) and OS (p=0.011). Marginally reduced DFS (p=0.068) and lower OS (p=0.039) were found in the high PLR cohort. On multivariate analysis, only preoperative LMR was an independent prognostic factor for both DFS (p=0.009, HR=1.639, 95% CI 1.129-2.381) and OS (p=0.004, HR=1.759, 95% CI 1.201-2.576) in ESCC patients.
Preoperative LMR better predicts cancer survival compared with the cellular components of systemic inflammation in patients with ESCC undergoing esophagectomy.
肿瘤细胞与炎症细胞之间的相互作用在食管鳞状细胞癌（ESCC）中尚未得到系统研究。本研究的目的是评估术前淋巴细胞与单核细胞比值（LMR）、中性粒细胞与淋巴细胞比值（NLR）以及血小板与淋巴细胞比值（PLR）是否能够预测接受食管切除术的ESCC患者的预后。
回顾性分析2007年1月至2008年12月期间218例经组织学确诊为ESCC且接受了根治性手术的患者的记录。除临床病理预后因素外，我们使用Kaplan-Meier曲线和Cox回归模型评估了LMR、NLR和PLR的预后价值。
中位随访时间为38.6个月（范围3 - 71个月）。通过应用受试者工作特征曲线（ROC）分析，选择LMR为2.57、NLR为2.60、PLR为244作为区分生存与死亡的最佳临界值。术前LMR低的患者的Kaplan-Meier生存分析显示，其无病生存期（DFS，p = 0.004）和总生存期（OS，p = 0.002）的预后明显比术前LMR高的患者差。高NLR组的DFS（p = 0.004）和OS（p = 0.011）较低。高PLR组的DFS略有降低（p = 0.068），OS较低（p = 0.039）。多因素分析显示，在ESCC患者中，只有术前LMR是DFS（p = 0.009，HR = 1.639，95% CI 1.129 - 2.381）和OS（p = 0.004，HR = 1.759，95% CI 1.201 - 2.576）的独立预后因素。
对于接受食管切除术的ESCC患者，与全身炎症的细胞成分相比，术前LMR能更好地预测癌症生存情况。
