Han L, Jia Y, Song Q, Wang N, Wang J, Bai B, Chen X, Wang C, Cheng Y
Department of Radiation Oncology, Qilu Hospital of Shandong University, Jinan, China.
Department of Oncology, Yiyuan Chinese Medicine Hospital, Zibo, China.
Dis Esophagus. 2016 Oct;29(7):740-746. doi: 10.1111/dote.12401. Epub 2015 Aug 28.
The objective of this study was to investigate the prognostic value of peripheral blood monocytes in esophageal squamous cell carcinoma (ESCC) patients who underwent esophagectomy. Records from 218 consecutive patients with histologically diagnosed ESCC who underwent esophagectomy at Qilu Hospital of Shandong University from January 2007 to December 2008 were retrospectively reviewed. The median disease-free survival (DFS) of this cohort was 29.0 months, and the 5-year DFS rate was 34.4%. The median overall survival (OS) was 35.0 months, and the 5-year OS rate was 37.6%. The cut-off value of 0.42 × 10 /L for the absolute monocyte count (AMC) was chosen as optimal to discriminate between survival and death by applying receiver operating curve analysis. There were 131 patients (60.1%) who had high AMC (≥0.42 × 10 /L) preoperatively. We found that AMC was significantly associated with gender, tumor location, and platelet count. Kaplan-Meier survival analysis of patients with high preoperative AMC had a significant worse prognosis for DFS (high vs. low: 27.5% vs. 39.0%, P = 0.015) and OS (high vs. low: 31.1% vs. 44.8%, P = 0.009) than those with low preoperative AMC. In a multivariate analysis, preoperative AMC was an independent prognostic factor for DFS (P = 0.025, hazard ratio [HR]: 1.469, 95% confidence interval [CI]: 1.050-2.054) and OS (P = 0.015, HR: 1.547, 95% CI: 1.088-2.200). In addition, among 140 patients without both preoperative and postoperative therapy, significantly worse OS (P = 0.012) and marginally reduced DFS (P = 0.079) were found in the high AMC cohort versus the low AMC cohort. A higher preoperative absolute peripheral monocyte count can be considered as a useful prognostic marker of ESCC patients who underwent esophagectomy.
本研究的目的是探讨外周血单核细胞对接受食管切除术的食管鳞状细胞癌（ESCC）患者的预后价值。回顾性分析了2007年1月至2008年12月在山东大学齐鲁医院接受食管切除术的218例经组织学诊断为ESCC的连续患者的记录。该队列的无病生存期（DFS）中位数为29.0个月，5年DFS率为34.4%。总生存期（OS）中位数为35.0个月，5年OS率为37.6%。通过应用受试者工作特征曲线分析，选择绝对单核细胞计数（AMC）的临界值0.42×10⁹/L作为区分生存和死亡的最佳值。术前有131例患者（60.1%）AMC高（≥0.42×10⁹/L）。我们发现AMC与性别、肿瘤位置和血小板计数显著相关。术前AMC高的患者的Kaplan-Meier生存分析显示，其DFS（高 vs. 低：27.5% vs. 39.0%，P = 0.015）和OS（高 vs. 低：31.1% vs. 44.8%，P = 0.009）的预后明显比术前AMC低的患者差。在多变量分析中，术前AMC是DFS（P = 0.025，风险比[HR]：1.469，95%置信区间[CI]：1.050 - 2.054）和OS（P = 0.015，HR：1.547，95%CI：1.088 - 2.200）的独立预后因素。此外，在140例未接受术前和术后治疗的患者中，高AMC队列的OS明显更差（P = 0.012），DFS略有降低（P = 0.079），而低AMC队列则不然。术前较高的外周绝对单核细胞计数可被视为接受食管切除术的ESCC患者的一个有用的预后标志物。
