Takahashi Keita, Masuda Takahiro, Ishikawa Yoshitaka, Tanishima Yuichiro, Kurogochi Takanori, Yuda Masami, Tanaka Yujiro, Matsumoto Akira, Yano Fumiaki, Eto Ken
Department of Gastrointestinal Surgery, Jikei University School of Medicine, Tokyo, Japan.
J Surg Oncol. 2023 Aug;128(2):196-206. doi: 10.1002/jso.27270. Epub 2023 Apr 3.
Preoperative C-reactive protein-to-albumin ratio (CAR) and neutrophil-to-lymphocyte ratio (NLR) are correlated with a poor prognosis of various cancers. The significance of postoperative systemic inflammation markers for prognostic stratification of patients with esophageal cancer (EC) has not been established. Therefore, this study aimed to elucidate the impact of postoperative CAR and NLR on survival in patients with EC for prognostic stratification.
A total of 235 patients who received curative esophagectomy were analyzed. A Cox proportional hazard model was performed to detect prognostic factors.
Multivariate analysis revealed that postoperative CAR ≥ 0.05 (hazard ratio [HR], 1.62; 95% confidence interval [CI], 1.01-2.57) and NLR ≥ 3.0 (HR, 2.81; 95% CI, 1.79-4.40) were independent prognostic factors for overall survival. Meanwhile, postoperative CAR ≥ 0.05 (HR, 1.61; 95% CI, 1.07-2.41) and NLR ≥ 3.0 (HR, 1.92; 95% CI, 1.29-2.85) were also significant prognostic factors for relapse-free survival. In addition, the patient group with postoperative CAR ≥ 0.05 and NLR ≥ 3.0 had the worst survival.
Postoperative CAR ≥ 0.05 and NLR ≥ 3.0 can predict the poor survival of patients who received curative esophagectomy for EC.
术前C反应蛋白与白蛋白比值（CAR）和中性粒细胞与淋巴细胞比值（NLR）与多种癌症的不良预后相关。食管癌（EC）患者术后全身炎症标志物对预后分层的意义尚未明确。因此，本研究旨在阐明术后CAR和NLR对EC患者生存的影响，以进行预后分层。
共分析了235例行根治性食管切除术的患者。采用Cox比例风险模型检测预后因素。
多因素分析显示，术后CAR≥0.05（风险比[HR]，1.62；95%置信区间[CI]，1.01 - 2.57）和NLR≥3.0（HR，2.81；95%CI，1.79 - 4.40）是总生存的独立预后因素。同时，术后CAR≥0.05（HR，1.61；95%CI，1.07 - 2.41）和NLR≥3.0（HR，1.92；95%CI，1.29 - 2.85）也是无复发生存的显著预后因素。此外，术后CAR≥0.05且NLR≥3.0的患者组生存最差。
术后CAR≥0.05和NLR≥3.0可预测接受根治性食管切除术的EC患者的不良生存情况。
