Department of Oncology Radiotherapy, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi Province, China.
Department of Department of Pathogenic Biology and Immunology, Medical School, Xi'an Jiaotong University, Xi'an, Shaanxi Province, China.
Technol Cancer Res Treat. 2024 Jan-Dec;23:15330338241272043. doi: 10.1177/15330338241272043.
Research on bone metastasis in esophageal cancer (EC) is relatively limited. Once bone metastasis occurs in patients, their prognosis is poor, and it severely affects their quality of life. Currently, there is a lack of convenient tumor markers for early identification of bone metastasis in EC. Our research aims to explore whether neutrophil-lymphocyte ratio (NLR) can predict bone metastasis in patients with EC.
Retrospective analysis of clinical indicators was performed on 604 patients with EC. They were divided into groups based on whether or not there was bone metastasis, and the patients' coagulation-related tests, blood routine, tumor markers and other indicators were collected. The receiver operating characteristic curve (ROC) were used to determine the predictive ability of parameters such as NLR for bone metastasis in EC, and univariate and multivariate logistic regression analyses were conducted to determine the impact of each indicator on bone metastasis. Using binary logistic regression to obtain the predictive probability of NLR combined with tumor markers.
ROC curves analysis suggested that the area under the curve (AUC) of the NLR was 0.681, with a sensitivity of 79.2% and a specificity of 52.6%, which can be used as a predictive factor for bone metastasis in EC. Multivariate logistic regression analysis showed that high NLR (odds ratio [OR]: 2.608, 95% confidence interval [CI]: 1.395-4.874, = 0.003) can function as an independent risk factor for bone metastasis in patients with EC. Additionally, high PT, high APTT, high FDP, high CEA, high CA724, low hemoglobin, and low platelet levels can also predict bone metastasis in EC. When NLR was combined with tumor markers, the area under the curve was 0.760 (95% CI: 0.713-0.807, < 0.001), significantly enhancing the predictability of bone metastasis in EC.
NLR, as a convenient, non-invasive, and cost-effective inflammatory indicator, could predict bone metastasis in EC. Combining NLR with tumor markers can significantly improve the diagnostic accuracy of bone metastasis in EC.
食管癌（EC）骨转移的研究相对较少。一旦患者发生骨转移，其预后较差，严重影响其生活质量。目前，对于 EC 骨转移的早期识别，缺乏方便的肿瘤标志物。本研究旨在探讨中性粒细胞-淋巴细胞比值（NLR）是否可预测 EC 患者的骨转移。
对 604 例 EC 患者进行临床指标回顾性分析。根据是否有骨转移将患者分为两组，收集患者的凝血相关检查、血常规、肿瘤标志物等指标。采用受试者工作特征曲线（ROC）确定 NLR 等参数对 EC 骨转移的预测能力，并进行单因素和多因素 logistic 回归分析，确定各指标对骨转移的影响。采用二项逻辑回归获得 NLR 联合肿瘤标志物的预测概率。
ROC 曲线分析表明，NLR 的曲线下面积（AUC）为 0.681，灵敏度为 79.2%，特异度为 52.6%，可作为 EC 骨转移的预测因素。多因素 logistic 回归分析显示，高 NLR（比值比[OR]：2.608，95%置信区间[CI]：1.395-4.874，=0.003）是 EC 患者骨转移的独立危险因素。此外，PT 升高、APTT 升高、FDP 升高、CEA 升高、CA724 升高、血红蛋白降低、血小板降低也可预测 EC 发生骨转移。当 NLR 与肿瘤标志物联合时，AUC 为 0.760（95%CI：0.713-0.807，<0.001），可显著提高 EC 骨转移的预测能力。
NLR 作为一种方便、无创、经济有效的炎症指标，可预测 EC 患者的骨转移。NLR 与肿瘤标志物联合可显著提高 EC 骨转移的诊断准确性。
