Blood biomarkers as predictors of pathological lymph node metastasis in clinical stage T1N0 esophageal squamous cell carcinoma
Blood biomarkers as predictors of pathological lymph node metastasis in clinical stage T1N0 esophageal squamous cell carcinoma
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DOI：
10.1093/dote/doac042
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发表时间：
2022-07-03
影响因子：
2.6
通讯作者：
Okada, Morihito
中科院分区：
文献类型：
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作者：
Ohsawa, Manato;Hamai, Yoichi;Okada, Morihito
准确的术前评估淋巴结(LN)转移对于确定浅表食道癌的治疗策略是非常重要的。血液生物标志物，如中性粒细胞-淋巴细胞、血小板-淋巴细胞和淋巴细胞-单核细胞比率(分别为NLR、PLR和LMR)，可作为不同癌症的LN转移的临床预测指标。在这里，我们研究了这些比率作为临床分期T1N0M0食管鳞癌(ESCC)患者病理LN转移和预后的预测指标。纳入2003年4月至2021年8月间行食道切除R0切除的185例cT1N0M0食管鳞癌患者。我们研究了预处理NLR、PLR和LMR预测病理性LN转移的能力。NLR、PLR和LMR预测病理性LN转移的最佳临界值分别为2.1、122和4.8。单因素和多因素分析显示，原发肿瘤的长度、侵袭深度和NLR是LN转移的显著预测因素。此外，与5年总生存率相似，低NLR组的5年无复发生存率明显好于高NLR组。NLR是预测病理性LN转移的最有用的指标。诊断为临床I期食管鳞癌和高NLR的患者需要充分的LN解剖，可能是术前辅助治疗的良好候选者。
Accurate preoperative evaluation of lymph node (LN) metastasis is important for determining the treatment strategy for superficial esophageal cancer. Blood biomarkers, such as the neutrophil-lymphocyte, platelet-lymphocyte, and lymphocyte-monocyte ratios (NLR, PLR, and LMR, respectively), have clinical applications as predictors of LN metastasis for different cancers. Here, we investigated the use of these ratios as predictors of pathological LN metastasis and prognosis in patients with clinical stage T1N0M0 esophageal squamous cell carcinoma (ESCC). Patients (n = 185) with cT1N0M0 ESCC who underwent esophagectomy with R0 resection between April 2003 and August 2021 were enrolled. We investigated the ability of pretreatment NLR, PLR, and LMR to predict pathological LN metastasis. The optimal cutoff values of NLR, PLR, and LMR to predict pathological LN metastasis were 2.1, 122, and 4.8, respectively. Univariate and multivariate analyses revealed that the primary tumor length, depth of invasion, and NLR were significant predictors of LN metastasis. Furthermore, similar to the 5-year overall survival, the 5-year relapse-free survival was significantly better in the low NLR group than in the high NLR group. The NLR was the most useful predictor of pathological LN metastasis. Patients diagnosed with clinical stage I ESCC and with a high NLR require adequate LN dissection and may be good candidates for preoperative adjuvant therapy.