Prognostic values of neutrophil-to-lymphocyte ratio and hemoglobin-to-white blood cell ratio on non-operative esophageal squamous cell carcinoma patients
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摘要: 目的 评价治疗前中性粒细胞与淋巴细胞比值(neutrophil-to-lymphocyte ratio,NLR)和血红蛋白与白细胞比值(hemoglobin-to-white blood cell ratio,HWR)对非手术治疗食管鳞癌(esophageal squamous cell carcinoma,ESCC)患者预后的影响。方法 对2009年10月~2014年11月在漳州市医院收治的362名非手术治疗食管鳞癌患者进行前瞻性分析。χ2检验分析NLR和HWR与患者一般临床特征之间的相关性;Cox比例风险回归模型进行单因素和多因素分析。结果 NLR和HWR最佳分界点分别为1.23和24.92;χ2检验分析结果表明,NLR与患者的性别、肿瘤长度、T分期、临床分期和空腹血糖水平相关;Cox单因素和多因素分析显示,高NLR和高HWR都与患者的不良预后有关;按不同治疗方式进行分层分析,提示NLR只在同期放化疗组中显示与患者预后相关(HR=4.080,95%CI:1.074~15.497,P=0.039),而HWR只在序贯放化疗组显示与患者预后相关(HR=2.625,95%CI:1.311~5.254,P=0.006)。结论 治疗前高NLR和高HWR均与非手术治疗食管鳞癌患者的不良预后有关。Abstract: Objective To evaluate the predictive value of neutrophil-to-lymphocyte ratio (NLR) and hemoglobin-to-white blood cell ratio (HWR) prior to treatment in prognosis of non-operative esophageal squamous cell carcinoma (ESCC) patients. Methods From October 2009 to November 2014, a total of 362 non-operative ESCC patients were enrolled in this prospective study. χ2 test was used to analyze the relationship between NLR, HWR and general clinical features; Univariate and multivariate Cox regression analysis was performed to evaluate the association between variables and prognosis of non-operative ESCC patients. Results The optimal cutoff level of 1.23 for NLR and 24.92 for HWR were identified by X-title software. χ2 test indicated NLR was significantly associated with gender, tumor length, T stage, TNM stage and fasting blood glucose level. Moreover, univariate and multivariate analyses showed that high NLR and high HWR were all associated with a poor prognosis in non-operative ESCC. However, when patients were specifically stratified by treatment modus, subset analysis showed that NLR was only predictive of prognosis in the concurrent chemoradiotherapy group (HR=4.080,95% CI:1.074-15.497,P=0.039), whereas the influence of HWR on prognosis was just existed in the sequential chemoradiotherapy group (HR=2.625,95% CI:1.311-5.254,P=0.006). Conclusions In this investigation, we found that high NLR and high HWR were associated with poor prognosis in non-operative ESCC.
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Key words:
- Esophageal squamous cell carcinoma /
- Prognostic /
- Epidemiologic methods
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