Song Qian, Wu Jun-Zhou, Wang Sheng
Department of Clinical Laboratory, Zhejiang Cancer Hospital, Key Laboratory of Head & Neck Cancer Translational Research of Zhejiang Province, Hangzhou 310022, China.
Cancer Research Institute, Zhejiang Cancer Hospital & Key Laboratory Diagnosis and Treatment Technology on Thoracic Oncology of Zhejiang Province, Hangzhou 310022, China.
J Thorac Dis. 2019 Jun;11(6):2332-2339. doi: 10.21037/jtd.2019.06.02.
Preoperative lymphocyte count (pre-LC) predicts the relapse and survival in patients with esophageal squamous cell carcinoma (ESCC), the clinical application of postoperative lymphocyte count (post-LC) change (LCc) remains unclear.
A retrospective analysis of patients with newly diagnosed ESCC who received curative resection from 2008 to 2015 was conducted. Complete blood counts from preoperative within seven days to postoperative within seven days were analyzed. LCc was defined as LCc increased (post-LC higher than pre-LC) and LCc decreased (post-LC lower than pre-LC). LCc was evaluated for an association with disease-free survival (DFS).
A total of 677 patients who reach the standard were enrolled into the study. There were 579 (85.5%) male and 98 (14.5%) female patients with ESCC. The median age was 61 years (range, 39-84 years). In univariate analysis, LCc significantly correlated to DFS (P=0.006, HR =0.593, 95% CI: 0.409-0.862). In multivariate analysis (COX model), LCc was an independent prognostic factor for DFS (P=0.011, HR =0.617, 95% CI: 0.424-0.897).
The dynamic change of LC after surgery may serve as a simple and new prognostic factor in patients with newly diagnosed ESCC.
术前淋巴细胞计数（pre-LC）可预测食管鳞状细胞癌（ESCC）患者的复发及生存情况，而术后淋巴细胞计数（post-LC）变化（LCc）的临床应用尚不清楚。
对2008年至2015年接受根治性切除的新诊断ESCC患者进行回顾性分析。分析术前7天内至术后7天内的全血细胞计数。LCc定义为LCc升高（post-LC高于pre-LC）和LCc降低（post-LC低于pre-LC）。评估LCc与无病生存期（DFS）的相关性。
共有677例符合标准的患者纳入研究。其中有579例（85.5%）男性和98例（14.5%）女性ESCC患者。中位年龄为61岁（范围39 - 84岁）。单因素分析中，LCc与DFS显著相关（P = 0.006，HR = 0.593，95%CI：0.409 - 0.862）。多因素分析（COX模型）中，LCc是DFS的独立预后因素（P = 0.011，HR = 0.617，95%CI：0.424 - 0.897）。
术后LC的动态变化可能是新诊断ESCC患者一个简单的新预后因素。
