McLaren Patrick J, Bronson Nathan W, Hart Kyle D, Vaccaro Gina M, Gatter Ken M, Thomas Charles R, Hunter John G, Dolan James P
Division of Gastrointestinal Surgery, Department of Surgery, Oregon Health and Science University, 3181 Sam Jackson Park Rd, Portland, OR, 97239, USA.
Department of General Surgery, Kaiser Permanente, Sunnyside, Portland, OR, USA.
J Gastrointest Surg. 2017 Apr;21(4):607-613. doi: 10.1007/s11605-016-3351-4. Epub 2017 Jan 12.
We hypothesized that serum neutrophil-to-lymphocyte and platelet-to-lymphocyte ratios may predict pathologic complete response to neoadjuvant chemoradiotherapy in esophageal cancer patients. The ability to predict favorable treatment response to therapy may aid in determining optimal treatment regimens.
A retrospective review of a prospective esophageal disease registry was conducted. Neutrophil-to-lymphocyte ratio was defined as the pre-chemoradiotherapy serum neutrophil count divided by lymphocyte count. Platelet-to-lymphocyte ratio was similarly defined. Logistic regression was applied to analyze these ratios and their effect on pathologic complete response. A Cox proportional-hazards model was used to analyze survival.
Sixty patients were included. Elevated neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio were both negative predictors of pathologic complete response (odds ratio: 0.62; 95% confidence interval: 0.37-0.89, P = 0.037 and odds ratio: 0.91; 95% confidence interval: 0.82-0.98, P = 0.028, respectively). Only platelet-to-lymphocyte ratio was predictive of decreased overall survival (hazard ratio: 1.05, 95% confidence interval: 0.94-1.16, P = 0.40).
Elevated neutrophil and platelet-to-lymphocyte ratios were significant predictors of a poor treatment response to neoadjuvant therapy. Only elevated platelet-to-lymphocyte ratio was predictive of worse overall survival. Neutrophil-to-lymphocyte and platelet-to-lymphocyte ratios may offer a simple serum test to assess the likelihood of a pathologic complete response after neoadjuvant therapy in esophageal cancer.
我们假设血清中性粒细胞与淋巴细胞比值及血小板与淋巴细胞比值可预测食管癌患者新辅助放化疗后的病理完全缓解情况。预测治疗反应良好的能力有助于确定最佳治疗方案。
对一个前瞻性食管疾病登记处进行回顾性研究。中性粒细胞与淋巴细胞比值定义为放化疗前血清中性粒细胞计数除以淋巴细胞计数。血小板与淋巴细胞比值的定义与之类似。应用逻辑回归分析这些比值及其对病理完全缓解的影响。采用Cox比例风险模型分析生存率。
纳入60例患者。中性粒细胞与淋巴细胞比值升高及血小板与淋巴细胞比值升高均为病理完全缓解的负性预测指标（比值比分别为：0.62；95%置信区间：0.37 - 0.89，P = 0.037；比值比为：0.91；95%置信区间：0.82 - 0.98，P = 0.028）。仅血小板与淋巴细胞比值可预测总生存期降低（风险比：1.05，95%置信区间：0.94 - 1.16，P = 0.40）。
中性粒细胞与淋巴细胞比值及血小板与淋巴细胞比值升高是新辅助治疗反应不佳的重要预测指标。仅血小板与淋巴细胞比值升高可预测总生存期更差。中性粒细胞与淋巴细胞比值及血小板与淋巴细胞比值可能提供一种简单的血清检测方法，以评估食管癌新辅助治疗后病理完全缓解的可能性。
