Division of Cancer and Genetics, University Hospital of Wales, Cardiff University, Heath Park, Cardiff, UK.
Department of Surgery, Cardiff & Vale University Health Board, University Hospital of Wales, Heath Park, Cardiff, UK.
Esophagus. 2021 Apr;18(2):267-277. doi: 10.1007/s10388-020-00772-3. Epub 2020 Aug 31.
The aim of this study was to assess the relative prognostic value of biomarkers to measure the systemic inflammatory response (SIR) and potentially improve prognostic modeling in patients undergoing potentially curative surgery for esophageal adenocarcinoma (EC).
Consecutive 330 patients undergoing surgery for EC between 2004 and 2018 within a regional UK cancer network were identified. Serum measurements of haemoglobin, C-reactive protein, albumin, modified Glasgow Prognostic Score (mGPS), and differential neutrophil to lymphocyte ratio (NLR) were obtained before surgery, and correlated with histopathological factors and outcomes. Primary outcome measures were disease-free (DFS) and overall survival (OS).
Of 330 OC patients, 294 underwent potentially curative esophagectomy. Univariable DFS analysis revealed pT, pN, pTNM stage (all p < 0.001), poor differentiation (p = 0.001), vascular invasion (p < 0.001), R1 status (p < 0.001), perioperative chemotherapy (p = 0.009), CRP (p = 0.010), mGPS (p = 0.011), and NLR (p < 0.001), were all associated with poor survival. Multivariable Cox regression analysis of DFS revealed only NLR [Hazard Ratio (HR) 3.63, 95% Confidence Interval (CI) 2.11-6.24, p < 0.001] retained significance. Multivariable Cox regression analysis of OS revealed similar findings: NLR [HR 2.66, (95% CI 1.58-4.50), p < 0.001].
NLR is an important SIR prognostic biomarker associated with DFS and OS in EC.
本研究旨在评估用于测量全身炎症反应（SIR）的生物标志物的相对预后价值，并可能改善接受食管腺癌（EC）根治性手术患者的预后模型。
在英国一个区域性癌症网络中，我们确定了 2004 年至 2018 年间连续接受 EC 手术的 330 例患者。在手术前获得了血红蛋白、C 反应蛋白、白蛋白、改良格拉斯哥预后评分（mGPS）和中性粒细胞与淋巴细胞比值（NLR）的血清测量值，并将其与组织病理学因素和结果相关联。主要观察指标是无病生存期（DFS）和总生存期（OS）。
在 330 例 OC 患者中，294 例接受了潜在根治性食管切除术。单变量 DFS 分析显示 pT、pN、pTNM 分期（均 p<0.001）、分化不良（p=0.001）、血管侵犯（p<0.001）、R1 状态（p<0.001）、围手术期化疗（p=0.009）、CRP（p=0.010）、mGPS（p=0.011）和 NLR（p<0.001）均与生存不良相关。DFS 的多变量 Cox 回归分析显示，只有 NLR [风险比（HR）3.63，95%置信区间（CI）2.11-6.24，p<0.001]仍具有显著性。OS 的多变量 Cox 回归分析也发现了类似的结果：NLR [HR 2.66，（95% CI 1.58-4.50），p<0.001]。
NLR 是与 EC 的 DFS 和 OS 相关的重要 SIR 预后生物标志物。
