Prognostic value of preoperative inflammatory response biomarkers in patients with esophageal cancer who undergo a curative thoracoscopic esophagectomy.
Prognostic value of preoperative inflammatory response biomarkers in patients with esophageal cancer who undergo a curative thoracoscopic esophagectomy.
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DOI：
10.1186/s12893-016-0179-5
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发表时间：
2016-09-20
期刊：
影响因子：
1.9
通讯作者：
Tajima Y
中科院分区：
文献类型：
--
作者：
Hirahara N;Matsubara T;Mizota Y;Ishibashi S;Tajima Y
一些炎症反应生物标志物，包括淋巴细胞与单核细胞比率（LMR）、中性粒细胞与淋巴细胞比率（NLR）和血小板与淋巴细胞比率（PLR），已被报道用于预测各种癌症的生存。本研究的目的是评估这些生物标志物在食管癌根治性切除患者中的临床价值。计算2006年1月至2015年2月147例连续食管切除术患者的LMR、NLR和PLR。我们研究了LMR、NLR和PLR在老年和非老年患者中的预后意义。我们评估了癌症特异性生存率（CSS），并根据病例记录或计算机记录确定了死亡原因。单因素分析显示TNM pStage （p < 0.0001）、肿瘤大小（p = 0.0014）、手术时间（p = 0.0209）、低LMR （p = 0.0008）、高PLR （p = 0.0232）是预后不良的重要危险因素。同时，通过多因素分析发现TNM pStage （p < 0.0001）和低LMR （p = 0.0129）与预后不良独立相关。在非老年患者中，单因素分析显示TNM pStage （p < 0.0001）、肿瘤大小（p = 0.0001）、手术时间（p = 0.0374）、LMR （p < 0.0001）和PLR （p = 0.0189）与较差的预后显著相关。多因素分析显示TNM pStage （p = 0.001）和LMR （p = 0.0007）是预后较差的独立危险因素。在老年患者中，单因素分析显示TNM pStage （p = 0.0023）是导致预后不良的唯一显著危险因素。LMR与食管癌根治性食管切除术后患者的肿瘤特异性生存（CSS）相关。特别是，低LMR是非老年患者生存差的重要独立预测因子。LMR方便、经济、易得，因此可以作为食管癌患者生存的标志。
Several inflammatory response biomarkers, including lymphocyte-to-monocyte ratio (LMR), neutrophil-to-lymphocyte ratio (NLR), and platelet-to-lymphocyte ratio (PLR) have been reported to predict survival in various cancers. The aim of this study is to evaluate the clinical value of these biomarkers in patients undergoing curative resection for esophageal cancer. The LMR, NLR and PLR were calculated in 147 consecutive patients who underwent esophagectomy between January 2006 and February 2015. We examined the prognostic significance of the LMR, NLR, and PLR in both elderly and non-elderly patients. We evaluated the cancer-specific survival (CSS), with the cause of death determined from the case notes or computerized records. Univariate analyses demonstrated that TNM pStage (p < 0.0001), tumor size (p = 0.0014), operation time (p = 0.0209), low LMR (p = 0.0008), and high PLR (p = 0.0232) were significant risk factors for poor prognosis. Meanwhile, TNM pStage (p < 0.0001) and low LMR (p = 0.0129) were found to be independently associated with poor prognosis via multivariate analysis. In non-elderly patients, univariate analyses demonstrated that TNM pStage (p < 0.0001), tumor size (p = 0.0001), operation time (p = 0.0374), LMR (p < 0.0001), and PLR (p = 0.0189) were significantly associated with a poorer prognosis. Multivariate analysis demonstrated that TNM pStage (p = 0.001) and LMR (p = 0.0007) were independent risk factors for a poorer prognosis. In elderly patients, univariate analysis demonstrated that that TNM pStage (p = 0.0023) was the only significant risk factor for a poor prognosis. LMR was associated with cancer-specific survival (CSS) of esophageal cancer patients after curative esophagectomy. In particular, a low LMR was a significant and independent predictor of poor survival in non-elderly patients. The LMR was convenient, cost effective, and readily available, and could thus act as markers of survival in esophageal cancer.