Han Dong, Zhang Jiajia, Zhao Jingjing, Lei Tongda, Chen Xi, Zhang Tian, Wei Hui, Guan Yong, Wang Jing, Zhang Wencheng, Zhao Lujun, Wang Jun, Yuan Zhiyong, Song Yongchun, Liu Ningbo, Pang Qingsong, Wang Ping
Department of Radiation Oncology, Tianjin Medical University Cancer Institute & Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin's Clinical Research Center for Cancer, Tianjin, China.
Ann Transl Med. 2020 Sep;8(18):1163. doi: 10.21037/atm-20-4053.
Neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and monocyte-to-lymphocyte ratio (MLR) are all markers of systemic inflammation response. The role of systemic inflammation in the development of esophageal fistula (EF) has yet to be defined. This study aimed to investigate the predictive value of hematologic measures of inflammation and to set up a predictive model.
The data of esophageal cancer (EC) patients who received chemoradiotherapy (CRT) in our institution between January, 2015 and January, 2018 were retrospectively collected. The NLR, PLR, and MLR of these enrolled patients were calculated. Univariate and multivariate analyses were performed to find the independent risk factors of EF. Moreover, a nomogram model was developed to predict the probability of fistula occurring in EC patients.
For PLR, the optimal cut-off value was 153. Patients with PLR >153 had a higher probability of developing fistula than those with PLR ≤153 (P<0.001). Multivariate analyses revealed that esophageal stenosis, ulcerative tumor, and PLR were independent factors for EF. Subsequently, a novel nomogram was set up with the C-index of 0.77 to predict the risk of developing EF in EC patients who received CRT.
PLR is an independent predictive indicator for EC patients who receive CRT. These findings will help to facilitate individual risk stratification for the development of EF in patients with EC.
中性粒细胞与淋巴细胞比值（NLR）、血小板与淋巴细胞比值（PLR）以及单核细胞与淋巴细胞比值（MLR）均为全身炎症反应的标志物。全身炎症在食管瘘（EF）发生发展中的作用尚未明确。本研究旨在探讨炎症血液学指标的预测价值并建立预测模型。
回顾性收集2015年1月至2018年1月在我院接受放化疗（CRT）的食管癌（EC）患者的数据。计算这些入选患者的NLR、PLR和MLR。进行单因素和多因素分析以找出EF的独立危险因素。此外，建立了列线图模型以预测EC患者发生瘘的概率。
对于PLR，最佳截断值为153。PLR>153的患者发生瘘的概率高于PLR≤153的患者（P<0.001）。多因素分析显示食管狭窄、溃疡性肿瘤和PLR是EF的独立因素。随后，建立了一个新的列线图，其C指数为0.77，用于预测接受CRT的EC患者发生EF的风险。
PLR是接受CRT的EC患者的独立预测指标。这些发现将有助于促进EC患者发生EF的个体风险分层。
