Preoperative inflammatory indexes are useful predictors of postoperative survival in patients with local-advanced esophageal squamous cell carcinoma_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

 LI Xiao ming , XIANG Zongjun , WAN Zhiyu , LU Yongguo , MU Haide , YIN Juntai

Department of Thoracic Surgery, Guangyuan Central Hospital, Guangyuan, 628000, Sichuan, P.R.China;

Corresponding author：

LI Xiao ming, Email: 506578540@qq.com

Keywords：

Preoperative inflammatory indexes ratio; advanced esophageal squamous cell carcinoma; esophagectomy; prognosis

DOI：

10.7507/1007-4848.201812031

Video：

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Objective To evaluate the prognostic value of preoperative inflammatory indexes in patients with local-advanced esophageal squamous cell carcinoma.Methods We retrospectively analyzed the clinical and prognostic data of 150 local-advanced esophageal squamous cell carcinoma patients who were treated by esophagectomy in Guangyuan Central Hospital from July 2014 to July 2015. There were 128 males and 22 females with average age of 62.23±8.48 years. The optimal cutoff value was determined by receiver operation characteristics (ROC) curve analysis. Patients were grouped according to the optimal cutoff values (NLR=3.49, PLR=152.28, MLR=0.36). Log-rank test, and multivariate Cox logistic regression modelling were used to assess the simultaneous influences of prognostic factors for survival outcomes after esophagectomy.Results The patients with higher ratio (NLR>3.49, PLR>152.28, MLR>0.36) had significantly shorter median progression free survival (PFS) and lower postoperative recurrent rate than those of the patients with lower ratio. The stratified analyses found that thelymph node staging and postoperative recurrent rate were positively correlated with the higher ratio. However, the tumor differentiation was negatively correlated with it. In univariate analyses, patients with preoperative NLR>3.49, PLR>152.28 and MLR>0.36 had a poorer prognosis. Furthermore, in multivariate analyses we found MLR>0.36 was also significantly associated with a decreased postoperative recurrent rate (HR=12.945, 95%CI 2.31 to 72.548, P=0.00).Conclusions The preoperative NLR, PLR and MLR are useful prognostic markers in patients with stage ⅢA-ⅣA esophageal squamous cell carcinoma who conducted esophagectomy.

Citation： LI Xiao ming, XIANG Zongjun, WAN Zhiyu, LU Yongguo, MU Haide, YIN Juntai. Preoperative inflammatory indexes are useful predictors of postoperative survival in patients with local-advanced esophageal squamous cell carcinoma. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2019, 26(9): 865-869. doi: 10.7507/1007-4848.201812031 Copy

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1. 曹小琴, 孙喜斌. 食管鳞癌发病水平及变化趋势. 中国肿瘤床, 2016, 43(21): 932-936.
2. 张永贞, 王国平, 许翊, 等. 食管鳞癌患者术后预后影响因素分析. 现代预防医学, 2011, 38(9): 1720-1723.
3. Cousens LM, Werb Z. Inflammation and cancer. Nature, 2002, 420(6917): 860-867.
4. Wu G, Yao Y, Bai C, et al. Combination of platelet to lymphocyte ratio and neutrophil to lymphocyte ratio is a useful prognostic factor in advanced non-small cell lung cancer patients. Thorac Cancer, 2015, 6(3): 275-287.
5. Fan W, Zhang Y, Wang Y, et al. Neutrophil-to-lymphocyte and platelet-to-lymphocyte ratios as predictors of survival and metastasis for recurrent hepatocellular carcinoma after transarterial chemoembolization. PLoS ONE, 2015, 10(3): e0119312.
6. Kim JH, Lee JY, Kim HK, et al. Prognostic significance of the neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio in patients with stage Ⅲ and Ⅳ colorectal cancer. World J Gastroenterology, 2017, 23(3): 505-515.
7. 何维, 曹雪涛, 熊思东, 等. 医学免疫学. 第2版. 北京: 人民卫生出版社, 2014.
8. Huang Y, Ma C, Zhang Q, et al. CD4+ and CD8+ T cells have opposing roles in breast cancer progression and outcome. Oncotarget, 2015, 6(19): 17462-17478.
9. Teng MWL, Galon J, Fridman W-H, Smyth MJ. From mice to humans: developments in cancer immunoediting. J Clin Invest, 2015, 125(9): 3338-3346.
10. Jiang X, Shapiro DJ. The immune system and inflammation in breast cancer. Mole Cell Endocrinology, 2014, 382(1): 673-682.
11. Inman KS, Francis AA, Murray NR. Complex role for the immune system in initiation and progression of pancreatic cancer. WJG, 2014, 20(32): 11160-11181.
12. Hirahara N, Fujii Y, Yamamoto T, et al. Validation of a novel prognostic scoring system using inflammatory response biomarkers in patients undergoing curative thoracoscopic esophagectomy for esophageal squamous cell carcinoma. Onco Targets Ther, 2017, 10: 363-370.
13. Nakamura K, Smyth MJ. Targeting cancer-related inflammation in the era of immunotherapy. Immunol Cell Biol, 2017, 95(4): 325-332.
14. Hosseini F, Mahdian-Shakib A, Jadidi-Niaragh F, et al. Anti-inflammatory and anti-tumor effects of alpha-l-guluronic acid (G2013) on cancer-related inflammation in a murine breast cancer model. Biomed Pharmacother, 2018, 98: 793-800.
15. Diakos CI, Charles KA, McMillan DC, et al. Cancer-related inflammation and treatment effectiveness. Lancet Oncol, 2014, 15(11): e493-e503.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Preoperative inflammatory indexes are useful predictors of postoperative survival in patients with local-advanced esophageal squamous cell carcinoma

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