Kijima Takashi, Arigami Takaaki, Uchikado Yasuto, Uenosono Yoshikazu, Kita Yoshiaki, Owaki Tetsuhiro, Mori Shinichiro, Kurahara Hiroshi, Kijima Yuko, Okumura Hiroshi, Maemura Kosei, Ishigami Sumiya, Natsugoe Shoji
Department of Digestive Surgery, Breast and Thyroid Surgery, Field of Oncology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan.
Molecular Frontier Surgery, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan.
Cancer Sci. 2017 Feb;108(2):193-199. doi: 10.1111/cas.13127.
Patients with advanced esophageal squamous cell carcinoma (ESCC) is received chemoradiotherapy or chemotherapy for clinical management. However, it is difficult to predict tumor response and prognosis using blood markers before starting treatments. The purpose of this study was to investigate the pre-treatment plasma fibrinogen and neutrophil-lymphocyte ratio (NLR) in patients with advanced ESCC treated with chemoradiotherapy or chemotherapy, and to assess the clinical utility of a combined score using these blood markers, named as the F-NLR (fibrinogen and NLR) score, as a predictor of tumor response and prognosis. A total of 98 advanced ESCC patients, treated with chemoradiotherapy or chemotherapy, were classified into three groups: F-NLR score of 2, having both hyperfibrinogenemia (>400 mg/dL) and high NLR (>3.0), score of 1, one of these hematological abnormalities, and score of 0, having neither hyperfibrinogenemia nor high NLR. Fibrinogen and NLR were significantly higher in the progressive disease (PD) group than the non-PD group (P = 0.0419, and P = 0.0001, respectively). A significantly higher F-NLR score was found in the PD group than the non-PD group (P = 0.0140). Overall survival was significantly lower in patients with an F-NLR score of 2 than in those with an F-NLR score of 0 or 1 (P < 0.0001). Multivariate analysis showed that the F-NLR score was one of the independent prognostic factors (P = 0.0081). Our study demonstrates that the F-NLR score is promising as a predictive marker for therapeutic effects and prognosis in patients with advanced ESCC.
晚期食管鳞状细胞癌（ESCC）患者接受放化疗或化疗进行临床治疗。然而，在开始治疗前，使用血液标志物难以预测肿瘤反应和预后。本研究的目的是调查接受放化疗或化疗的晚期ESCC患者治疗前的血浆纤维蛋白原和中性粒细胞与淋巴细胞比值（NLR），并评估使用这些血液标志物的联合评分（称为F-NLR（纤维蛋白原和NLR）评分）作为肿瘤反应和预后预测指标的临床实用性。共有98例接受放化疗或化疗的晚期ESCC患者被分为三组：F-NLR评分为2，即同时存在高纤维蛋白原血症（>400mg/dL）和高NLR（>3.0）；评分为1，即存在上述血液学异常之一；评分为0，即既无高纤维蛋白原血症也无高NLR。进展期疾病（PD）组的纤维蛋白原和NLR显著高于非PD组（分别为P = 0.0419和P = 0.0001）。PD组的F-NLR评分显著高于非PD组（P = 0.0140）。F-NLR评分为2的患者总生存期显著低于评分为0或1的患者（P < /0.0001）。多变量分析显示F-NLR评分是独立的预后因素之一（P = 0.0081）。我们的研究表明，F-NLR评分有望作为晚期ESCC患者治疗效果和预后的预测指标。
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