Zhang Xiangwei, Jiang Yuanzhu, Wang Yang, Wang Zhaoyang, Zhao Linping, Xue Xianbiao, Sang Shaowei, Zhang Lin
Department of Thoracic Surgery.
Department of Medical Imaging, Shandong Provincial Hospital Affiliated to Shandong University, Shandong University, Jinan.
Medicine (Baltimore). 2018 Dec;97(49):e13585. doi: 10.1097/MD.0000000000013585.
The prognostic role of neutrophil-to-lymphocyte ratio (NLR) in esophageal cancer (EC) remains controversial.
The aim of this study was to evaluate the association between NLR and oncologic outcome of EC patients through a meta-analysis. A systematic search was performed in PubMed, Web of Science and Embase for relevant studies. Meta-analysis was performed using hazard ratio (HR) and95% confidence interval (CI) as effect measures.
Finally, 33 articles with 11,039patients were included in our study. The synthesized results indicated that the elevated NLR was negatively related to overall survival (OS) (HR = 1.39, 95% CI: 1.23-1.54). When the patients were stratified according to country, pathological type, treatment strategies, sample size, and different HR estimate method, high NLR was also significantly correlated with poor OS. Similarly, elevated NLR was also associated with shorter disease-free survival (DFS), progress-free survival (PFS), relapse-free survival (RFS), and cancer-specific survival (CSS).
The elevated pretreatment NLR is associated with poor oncological outcomes in patients with EC. NLR may be a significant predictive biomarker in EC. Further large-cohort studies are needed to confirm these findings.
中性粒细胞与淋巴细胞比值（NLR）在食管癌（EC）中的预后作用仍存在争议。
本研究旨在通过荟萃分析评估NLR与EC患者肿瘤学结局之间的关联。在PubMed、科学网和Embase中进行了相关研究的系统检索。使用风险比（HR）和95%置信区间（CI）作为效应量进行荟萃分析。
最终，本研究纳入了33篇文章，共11039例患者。综合结果表明，NLR升高与总生存期（OS）呈负相关（HR = 1.39，95% CI：1.23 - 1.54）。当根据国家、病理类型、治疗策略、样本量和不同的HR估计方法对患者进行分层时，高NLR也与较差的OS显著相关。同样，NLR升高也与无病生存期（DFS）、无进展生存期（PFS）、无复发生存期（RFS）和癌症特异性生存期（CSS）缩短有关。
治疗前NLR升高与EC患者不良的肿瘤学结局相关。NLR可能是EC中一个重要的预测生物标志物。需要进一步的大型队列研究来证实这些发现。
