Department of Thoracic Surgery, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China.
Thorac Cancer. 2018 Dec;9(12):1707-1715. doi: 10.1111/1759-7714.12885. Epub 2018 Oct 12.
This study investigated the relationship between the neutrophil-to-lymphocyte ratio (NLR) and clinicopathological features and prognosis in patients with postoperative esophageal squamous cell carcinoma (ESCC).
The preoperative NLR was evaluated in 419 patients who underwent esophagectomy for ESCC. A receiver operating characteristic (ROC) curve was plotted to verify the accuracy of the NLR for predicting survival. Correlation between the NLR and clinicopathological characteristics was analyzed using the χ test. Prognostic influence was calculated by using the Kaplan-Meier method and the difference was assessed by log-rank test. Multivariate Cox regression models were applied to evaluate the independent prognostic value.
The cutoff value of the NLR was 2.998, the area under the curve was 0.735, and the sensitivity and specificity were 69.3% and 69.3%, respectively. Tumor length (P = 0.0317), lymph node metastasis (P = 0.0352), pathological tumor node metastasis (pTNM) stage (P = 0.0271), and postoperative radiotherapy (P = 0.0385) were significantly different between the groups. Multivariate analysis showed that pTNM stage (P = 0.0098), lymph node metastasis (P = 0.001), and NLR (P = 0.0022) were independent prognostic factors for survival. Moreover, when patients were stratified by TNM stage, the adverse effects of preoperative NLR on cancer-specific survival were greater in patients with stage II and III ESCC and in patients with lymph node metastasis.
The preoperative NLR is significantly correlated with long-term prognosis in postoperative patients with ESCC, particularly in patients with lymph node metastasis and stage II and III ESCC.
本研究旨在探讨中性粒细胞与淋巴细胞比值（NLR）与术后食管鳞状细胞癌（ESCC）患者临床病理特征和预后的关系。
对 419 例行 ESCC 根治性切除术的患者进行术前 NLR 评估。绘制受试者工作特征（ROC）曲线以验证 NLR 预测生存的准确性。采用 χ²检验分析 NLR 与临床病理特征的相关性。采用 Kaplan-Meier 法计算预后影响，对数秩检验评估差异。采用多因素 Cox 回归模型评估独立预后价值。
NLR 的截断值为 2.998，曲线下面积为 0.735，灵敏度和特异度分别为 69.3%和 69.3%。肿瘤长度（P = 0.0317）、淋巴结转移（P = 0.0352）、病理肿瘤淋巴结转移（pTNM）分期（P = 0.0271）和术后放疗（P = 0.0385）在两组间差异有统计学意义。多因素分析显示，pTNM 分期（P = 0.0098）、淋巴结转移（P = 0.001）和 NLR（P = 0.0022）是生存的独立预后因素。此外，当根据 TNM 分期对患者进行分层时，术前 NLR 对 II 期和 III 期 ESCC 患者以及有淋巴结转移患者的癌症特异性生存的不良影响更大。
术前 NLR 与术后 ESCC 患者的长期预后显著相关，尤其是在有淋巴结转移和 II 期和 III 期 ESCC 患者中。
