外周血中性粒细胞与淋巴细胞比值对老年转移性食管癌免疫治疗预后的影响

Predictive value of peripheral blood neutrophil to lymphocyte ratio on prognosis for elderly patients with metastatic esophageal cancer after immunotherapy

目的 评估外周血中性粒细胞/淋巴细胞比值(neutrophil/lymphocyte ratio,NLR)对老年转移性食管癌病人免疫治疗预后的预测价值。方法 回顾性分析116例老年转移性食管癌病人免疫治疗前的临床资料及外周血数据。通过X-tile软件确定NLR的最佳临界值,采用单因素及多因素Cox回归模型分析影响预后的因素,并使用Kaplan-Meier法针对相关风险因素绘制生存曲线。结果 NLR的最佳临界值为2.8,以此将病人分为低NLR组和高NLR组。Cox回归分析显示,NLR、美国东部肿瘤协作组(ECOG)评分是老年转移性食管癌免疫治疗预后的独立影响因素,NLR<2.8与更长的PFS(P<0.001)和更长的OS(P<0.001)相关。结论 NLR水平可以预测老年转移性食管癌病人免疫治疗的疗效,可能是一种简单、经济、有效的预后指标。

Objective To evaluate the predictive value of peripheral blood neutrophil/lymphocyte ratio(NLR) on the prognosis of the elderly patients with metastatic esophageal cancer who received immunotherapy.Methods The clinical data of 116 elderly patients with metastatic esophageal cancer before immunotherapy were retrospectively analyzed.The optimal critical value of NLR was determined by X-tile software,and single factor and multiple factor Cox regression model was used to analyze the influencing factors for prognosis.Kaplan-Meier method was used to plot survival curves for relevant risk factors.Results The optimal threshold value of NLR before treatment was 2.8,according to which the patients were divided into low NLR group and high NLR group.Cox regression showed that NLR and Eastern Cooperative Oncology Group(ECOG) score before treatment were the independent risk factors for the prognosis of the elderly patients with metastatic esophageal cancer after immunotherapy.NLR<2.8 before treatment was associated with longer progression free survival(PFS)(P<0.001) and longer overall survival(OS)(P<0.001).Conclusions The NLR level can predict the efficacy of immunotherapy in the elderly patients with metastatic esophageal cancer,and may be a simple,economical,and effective prognostic indicator.