Lymphopenia predicts poor prognosis in patients with esophageal squamous cell carcinoma.
Lymphopenia predicts poor prognosis in patients with esophageal squamous cell carcinoma.
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DOI：
10.1097/md.0000000000000257
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发表时间：
2014-12
期刊：
影响因子：
1.6
通讯作者：
Huang Y
中科院分区：
文献类型：
--
作者：
Feng JF;Liu JS;Huang Y
淋巴细胞减少症是几种癌症的有用预测因子。本研究的目的是确定食管鳞状细胞癌（ESCC）患者淋巴细胞减少的预后价值。对307例因ESCC接受食管切除术的连续患者进行了回顾性分析。在我们的研究中，淋巴细胞计数（LC）低于1.0 Giga/L被定义为淋巴细胞减少症。 Kaplan-Meier法计算肿瘤特异性生存期（CSS）。采用考克斯回归分析影响预后的因素。绘制受试者工作特征（ROC）曲线以验证LC预测CSS的准确性。平均LC为1.55 ± 0.64 Giga/L（范围0.4-3.7 Giga/L）。 淋巴细胞减少（LC <1.0Giga/L）发生率为16.6%（51/307）。 淋巴细胞减少症（LC <1.0 Giga/L）患者的5年CSS显著缩短（21.6% vs 43.8%，P = 0.004）。 多因素分析显示淋巴细胞减少（LC <1.0Giga/L）是食管鳞癌患者的独立预后因素（P = 0.013）。 CSS的淋巴细胞减少症风险比（HR）为1.579 [95%置信区间（CI）：1.100-2.265]。ROC曲线显示淋巴细胞减少（LC <1.0Giga/L）预测生存的敏感性为86.2%，特异性为27.2%。 淋巴细胞减少（LC <1.0 Giga/L）仍是食管鳞癌患者长期生存的独立预测因素。
Lymphopenia is a useful predictive factor in several cancers. The aim of this study was to determine the prognostic value of lymphopenia in patients with esophageal squamous cell carcinoma (ESCC). A retrospective analysis of 307 consecutive patients who had undergone esophagectomy for ESCC was conducted. In our study, a lymphocyte count (LC) of fewer than 1.0 Giga/L was defined as lymphopenia. Kaplan–Meier method was used to calculate the cancer-specific survival (CSS). Cox regression analyses were performed to evaluate the prognostic factors. Receiver operating characteristic (ROC) curve was also plotted to verify the accuracy of LC for CSS prediction. The mean LC was 1.55 ± 0.64 Giga/L (range 0.4–3.7 Giga/L). The incidence of lymphopenia (LC < 1.0 Giga/L) was 16.6% (51/307). Patients with lymphopenia (LC < 1.0 Giga/L) had a significantly shorter 5-year CSS (21.6% vs 43.8%, P = 0.004). On multivariate analysis, lymphopenia (LC < 1.0 Giga/L) was an independent prognostic factor in patients with ESCC (P = 0.013). Lymphopenia had a hazard ratio (HR) of 1.579 [95% confidence interval (CI): 1.100–2.265] for CSS. ROC curve demonstrated that lymphopenia (LC < 1.0 Giga/L) predicts survival with a sensitivity of 86.2% and a specificity of 27.2%. Lymphopenia (LC < 1.0 Giga/L) is still an independent predictive factor for long-term survival in patients with ESCC.