Xu Xiaoqin, Sun Ting, Zhang Xiaofang, Wang Weigang, Ji Yanfen, Jing Jiexian
Department of Clinical Laboratory, Shanxi Province Cancer Hospital, Shanxi Hospital Affiliated to Cancer Hospital, Chinese Academy of Medical Sciences, Cancer Hospital Affiliated to Shanxi Medical University, Taiyuan, Shanxi Province, People's Republic of China.
BMC Cancer. 2025 Apr 9;25(1):652. doi: 10.1186/s12885-025-14010-5.
To explore the clinical significance of albumin(Alb) to the derive(d) neutrophil-to-lymphocyte ratio(NLR) in patients with esophageal squamous cell carcinoma (ESCC) aged 60 years and above.
328 patients with ESCC at Shanxi Province Cancer Hospital were enrolled in this study. The dNLR was calculated using the following formula: neutrophil count / (leukocyte count - neutrophil count). Alb to dNLR or the Alb/dNLR ratio was calculated by dividing the Alb level by the dNLR level.Receiver operating characteristic (ROC) curve analysis was used to determine the cutoff values for Alb to dNLR.
ROC analysis displayed that the cut-off value of Alb to dNLR was defined to be 20.28 U/mL. The AlbtodNLR was not related to clinical features but to survival status (all P > 0.05). ESCC patients aged 60 years and above with a high AlbtodNLR had better survival than those with a low Alb-to-dNLR (P = 0.005). Similar results were observed in male patients with ESCC (P = 0.001), subgroups with upper and middle locations (P = 0.013 and 0.017), tobacco consumption (P = 0.004), non-drinkers (P = 0.029), well and moderate differentiation (P = 0.014), lymph node involvement (P < 0.001), advanced T stage (P = 0.014), and advanced TNM staging (P = 0.001). Univariate Cox regression analysis indicated that tumor grade, T staging, lymph node metastasis(LNM), TNM staging, and Alb to dNLR ratio were predictors of death from ESCC. In a multivariate Cox regression analysis, a lower AlbtodNLR levels, and advanced T stage were associated with an increased risk of ESCC-related death.
Collectively, Alb to dNLR were inversely associated with outcome and were regarded as an independent influencing factor for ESCC subpopulation aged 60 years and above.
探讨白蛋白（Alb）与衍生中性粒细胞与淋巴细胞比值（NLR）在60岁及以上食管鳞状细胞癌（ESCC）患者中的临床意义。
本研究纳入山西省肿瘤医院的328例ESCC患者。采用以下公式计算衍生中性粒细胞与淋巴细胞比值（dNLR）：中性粒细胞计数/（白细胞计数-中性粒细胞计数）。白蛋白与衍生中性粒细胞与淋巴细胞比值（Alb/dNLR）通过白蛋白水平除以衍生中性粒细胞与淋巴细胞比值水平计算得出。采用受试者工作特征（ROC）曲线分析确定白蛋白与衍生中性粒细胞与淋巴细胞比值的临界值。
ROC分析显示，白蛋白与衍生中性粒细胞与淋巴细胞比值的临界值定义为20.28 U/mL。白蛋白与衍生中性粒细胞与淋巴细胞比值与临床特征无关，但与生存状态有关（所有P>0.05）。60岁及以上的ESCC患者中，白蛋白与衍生中性粒细胞与淋巴细胞比值高的患者比白蛋白与衍生中性粒细胞与淋巴细胞比值低的患者生存更好（P=0.005）。在男性ESCC患者（P=0.001）、肿瘤位于上中段的亚组（P=0.013和0.017）、吸烟患者（P=0.004）、不饮酒者（P=0.029）、高分化和中分化患者（P=0.014）、有淋巴结转移患者（P<0.001）、T分期晚期患者（P=0.014）和TNM分期晚期患者（P=0.001）中观察到类似结果。单因素Cox回归分析表明，肿瘤分级、T分期、淋巴结转移（LNM）、TNM分期和白蛋白与衍生中性粒细胞与淋巴细胞比值是ESCC死亡的预测因素。多因素Cox回归分析显示，较低的白蛋白与衍生中性粒细胞与淋巴细胞比值水平和T分期晚期与ESCC相关死亡风险增加有关。
总体而言，白蛋白与衍生中性粒细胞与淋巴细胞比值与预后呈负相关，被视为60岁及以上ESCC亚群的独立影响因素。
