摘要
目的探讨术前外周血中性粒细胞与淋巴细胞比值（NLR）在食管鳞状细胞癌患者预后评估中的价值。方法回顾性分析2007年1月至2008年12月在中国医学科学院肿瘤医院接受根治性手术切除的475例食管鳞癌患者的临床资料，均经术后病理证实。以NLR=2．5作为临界值，高NLR组（≥2．5）86例，低NLR组（〈2．5）389例，所有患者术前均未接受放化疗。结果全组患者术前NLR为0．53—11，中位值为1．77。高NLR组和低NLR组患者的5年生存率分别为36．0％和48．6％，差异有统计学意义（P=0．009）。低NLR组中女性所占比例大于高NLR组（P=0．04）。单因素分析结果显示，年龄、吸烟史、T分期、N分期、术后辅助治疗情况和NLR是患者预后的影响因素（均P〈0．05）。Cox多因素分析结果显示，年龄、N分期、接受辅助治疗情况和NLR是影响患者预后独立影响因素（均P〈0．05）。而在伴有淋巴结转移的食管鳞癌患者中，低NLR和高NLR组患者的5年生存率分别为33．5％和27．9％，差异有统计学意义（P〈0．001）。结论对于接受根治性手术切除的食管鳞癌患者，术前外周血NLR≥2．5是预后不良的独立影响因素。
Objective To investigate the prognostic significance of the preoperative neutrophil-to- lymphocyte ratio （NLR） in patients with esophageal squamous cell carcinoma （ESCC） who received radical resection. Methods A restropective review was performed on 475 patients who underwent radical resection for ESCC in our hospital between January 2007 and December 2008, all patients were diagnosed with ESCC by pathological examination. None accepted neoadjuvant therapy. Results The median value of NLR was 1.77 （range, 0.53-11 ）. Based on this cut-off value of 2.5, all the patients were divided into 2 groups ： a low NLR （ 〈 2.5, n = 389） group and a high NLR （ ≥2.5, n = 86） group. The 5-year overall survival rate was 48.6% in patients of the low NLR group and 36.0% in those of the high NLR group （P = 0.009）. The ratio of women was higher in the low NLR group （P = 0.04）. Univariate analysis showed NLR, age, history of smoking, T stage, N stage, and postopertative adjuvant therapy were associated with survival （P 〈 0.05 for all）. We also found that NLR could be used to divide patients with or without lymph node metastasis into a high and low risk groups. Multivariate analysis revealed that NLR, age, N stage, and postoperative adjuvant therapy were independent risk factors of prognosis. Conclusion Our results show that preoperative NLR ≥2.5 may be a convenient biomarker to predict patients with a poor prognosis after radical resection for ESCC.
出处
《中华肿瘤杂志》
CAS
CSCD
北大核心
2014年第4期294-297,共4页
Chinese Journal of Oncology
基金
国家高技术研究发展计划（2012AA02A503）
国家自然科学基金（81172336、81372219、81301851）
关键词
食管肿瘤
癌
鳞状细胞
预后
中性粒细胞与淋巴细胞比值
Esophageal neoplasms
Carcinoma, squamous cell
Prognosis
Neutrophil-to- lymphocyte ratio
