术前中性粒细胞与淋巴细胞比值预测新辅助化疗后微创食管癌切除术患者的预后。
Preoperative neutrophil-to-lymphocyte ratio predicts the prognosis of esophageal squamous cell cancer patients undergoing minimally invasive esophagectomy after neoadjuvant chemotherapy.
机构信息
Division of Gastrointestinal Surgery, Department of Surgery, Graduate School of Medicine, Kobe University, Kobe, Hyogo, Japan.
Division of Minimally Invasive Surgery, Department of Surgery, Graduate School of Medicine, Kobe University, Kobe, Hyogo, Japan.
出版信息
J Surg Oncol. 2021 Dec;124(7):1022-1030. doi: 10.1002/jso.26611. Epub 2021 Aug 30.
BACKGROUND
One of the primary treatment for resectable advanced esophageal squamous cell cancer (ESCC) is neoadjuvant chemotherapy (NAC) followed by minimally invasive esophagectomy (MIE). Because the neutrophil-to-lymphocyte ratio (NLR) is a widely reported prognostic factor in several cancers, we investigated whether the preoperative NLR is a biomarker in ESCC patients treated with NAC and MIE.
METHODS
In this study, we investigated 174 ESCC patients who underwent MIE from January 2010 to December 2015, including 121 patients who received NAC. The cutoff value of the NLR was analyzed using the receiver operating characteristic curve. Multivariate analyses were performed to clarify independent prognostic factors for overall survival (OS).
RESULTS
The cutoff value of the NLR for OS in 121 patients who received NAC was 2.5 ng/ml, and the area under the curve was 0.63026 (p = 0.0127). The 5-year OS rate was 64% in those with an NLR <2.5 and 39% in those with an NLR ≥2.5. According to multivariate analysis, NLR ≥2.5, pathological T, pathological N, and intraoperative blood loss of >415 ml were independent poor prognostic factors.
CONCLUSIONS
NLR is a biomarker of prognosis in ESCC patients who undergo MIE after NAC.
背景
可切除的晚期食管鳞状细胞癌（ESCC）的主要治疗方法之一是新辅助化疗（NAC）后进行微创食管切除术（MIE）。由于中性粒细胞与淋巴细胞比值（NLR）是几种癌症中广泛报道的预后因素，我们研究了术前 NLR 是否是接受 NAC 和 MIE 治疗的 ESCC 患者的生物标志物。
方法
本研究纳入了 2010 年 1 月至 2015 年 12 月期间接受 MIE 的 174 例 ESCC 患者，其中 121 例患者接受了 NAC。使用受试者工作特征曲线分析 NLR 的截断值。进行多变量分析以明确总生存期（OS）的独立预后因素。
结果
接受 NAC 的 121 例患者中，NLR 对 OS 的截断值为 2.5ng/ml，曲线下面积为 0.63026（p=0.0127）。NLR<2.5 的患者 5 年 OS 率为 64%，而 NLR≥2.5 的患者为 39%。根据多变量分析，NLR≥2.5、病理 T、病理 N 和术中出血量>415ml 是独立的不良预后因素。
结论
NLR 是接受 NAC 后行 MIE 的 ESCC 患者预后的生物标志物。
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