Hirahara Noriyuki, Fujii Yusuke, Yamamoto Tetsu, Hyakudomi Ryoji, Hirayama Takanori, Taniura Takahito, Ishitobi Kazunari, Tajima Yoshitsugu
Department of Digestive and General Surgery, Shimane University Faculty of Medicine, Shimane, Japan.
Onco Targets Ther. 2017 Jan 13;10:363-370. doi: 10.2147/OTT.S124556. eCollection 2017.
Systemic inflammatory markers, including the lymphocyte-to-monocyte ratio, neutrophil-to-lymphocyte ratio, and platelet-to-lymphocyte ratio have been shown to predict postoperative recurrence and survival in various types of cancer. However, their role in esophageal cancer has yet to be determined. This study aimed to evaluate the prognostic significance of an inflammatory response biomarker (IRB) score, independent of conventional clinicopathological criteria, in patients with esophageal cancer undergoing curative resection.
We retrospectively reviewed a database containing the medical records of 147 consecutive patients who underwent curative esophagectomy for esophageal squamous cell carcinoma. The IRB score was determined as follows: a low lymphocyte-to-monocyte ratio (<4), a low neutrophil-to-lymphocyte ratio (<1.6), and a high platelet-to-lymphocyte ratio (>147), which were each scored as 1, with all remaining values scored as 0. The scores were added together to produce the IRB score (range: 0-3).
An IRB score of 2-3 (hazard ratio: 6.023, 95% confidence interval: 1.675-13.078; <0.01) was identified as an independent poor prognostic factor of cancer-specific survival (CSS) in a multivariate logic regression analysis. The 5-year CSS rates in patients with the IRB scores of 0-1, 2, and 3 were 37.8%, 67.8%, and 72.5%, respectively. As determined by Kaplan-Meier analysis and the log-rank test, these differences were significant (<0.001).
The IRB score can predict the systemic inflammatory response as accurately as conventional tumor markers and is useful for determining CSS in patients with esophageal cancer undergoing curative thoracoscopic esophagectomy.
包括淋巴细胞与单核细胞比值、中性粒细胞与淋巴细胞比值以及血小板与淋巴细胞比值在内的全身炎症标志物已被证明可预测各类癌症的术后复发和生存情况。然而，它们在食管癌中的作用尚未确定。本研究旨在评估炎症反应生物标志物（IRB）评分在接受根治性切除的食管癌患者中的预后意义，该评分独立于传统临床病理标准。
我们回顾性分析了一个数据库，其中包含147例连续接受食管鳞状细胞癌根治性食管切除术患者的病历。IRB评分的确定方法如下：淋巴细胞与单核细胞比值低（<4）、中性粒细胞与淋巴细胞比值低（<1.6）以及血小板与淋巴细胞比值高（>147），每项评分为1，其余所有值评分为0。将这些分数相加得出IRB评分（范围：0 - 3）。
在多因素逻辑回归分析中，IRB评分为2 - 3（风险比：6.023，95%置信区间：1.675 - 13.078；P<0.01）被确定为癌症特异性生存（CSS）的独立不良预后因素。IRB评分为0 - 1、2和3的患者5年CSS率分别为37.8%、67.8%和72.5%。通过Kaplan - Meier分析和对数秩检验确定，这些差异具有显著性（P<0.001）。
IRB评分能够像传统肿瘤标志物一样准确预测全身炎症反应，并且有助于确定接受根治性胸腔镜食管切除术的食管癌患者的CSS情况。
