中性粒细胞与淋巴细胞比值与食管鳞癌患者临床病理特征的相关性及其在预后评估中的价值分析

Correlation between neutrophil to lymphocyte ratio and clinicopathological features of patients with esophageal squamous cell carcinoma and its value in prognostic evaluation

[目的]旨在探讨术前中性粒细胞与淋巴细胞比值(NLR)与食管鳞癌患者临床病理特征的相关性及其在预后评估中的价值。[方法]收集我院2010年1月~2011年12月收治的103例食管鳞癌患者的临床资料进行回顾性分析。根据患者NLR水平,将患者分为低NLR组(NLR<2.23,n=60)及高NLR组(NLR≥2.23,n=43),比较2组患者的临床病理特征,采用Cox回归分析模型探讨影响食管鳞癌预后的独立危险因素。[结果]高NLR组TNM分期Ⅲ期者、未分化+低分化者比例明显高于多于NLR组,差异有统计学意义(P<0.01);低NLR组3年、5年总生存率分别为58.33%(35/60)、36.66%(22/60),明显低于高NLR组37.20%(16/43)、18.60%(8/43),差异有统计学意义(P<0.05);TNM分期、肿瘤分化程度、治疗方式、NLR值是影响食管鳞癌患者预后生存的单因素(P<0.01),进一步经Cox回归分析后显示,TNM分期(Ⅲ期)、肿瘤分化程度(未分化+低分化)、治疗方式(单纯手术)、NLR值(≥2.23)是影响食管鳞癌患者预后生存的独立危险因素(P<0.01)。[结论]术前NLR比值水平可作为食管鳞癌患者预后的评估指标,术前高NLR水平者其预后不佳。

[Objective]To investigate the correlation between neutrophil to lymphocyte ratio and clinico- pathological features of patients with esophageal squamous cell carcinoma and its value in prognostic evalu- ation. [Methods]The clinical data of 103 patients with esophagus squamous cell carcinoma treated in our hospital from January 2010 to December 2011 were retrospectively analyzed. According to the level of NLR patients, the patients were divided into low N LR group（NLR^2.23, n ~ 60）and high NLR group （NLR~ 2.23 ,n=43）. The clinical and pathological features of two groups were compared. Cox regression analysis was used to explore the influence of independent risk factors for the prognosis of esophageal squamous cell carcinoma. [Results]The proportion of TNM stage III, undifferentiated and low differentiation in high NLR group were significantly higher than that of NLR group, the difference was statistically significant （P〈0. 001）. The 3 years and 5 years total survival rates in low NLR group were 58. 33% （35/60）and 36.66% （22/60）respectively, which were significantly lower than that in high NLR group[37.20% （16/43）and 18.60% （8/43）-],the difference were statistically significant（P〈0.05）. The single factors influencing the prognosis of patients with esophageal squamous cell carcinoma included TNM stage,tumor differentiation, treatment and NLR value（P〈0.01）. Cox regression analysis showed that TNM stage（stage III）,tumor differentiation degree（undifferentiated and low differentiated）and the way of treatment（surgery）, NLR val- ue（≥2.23）were independent risk factors for survival prognosis of patients with esophageal squamous cell carcinoma（P〈0.01）. [Conclusion]Preoperative NLR can be used as an indicator of prognosis in patients with esophagus squamous cell carcinoma. The prognosis of patients with high preoperative NLR is poor.