Investigation Of The Correlation Between Neutrophil Lymphocyte Ratio And Platelet Lymphocyte Ratio With Radiotherapy Efficacy And Prognosis In Patients With Esophageal Squamous Cell Carcinoma

Objective: To explore the correlation between neutrophil lymphocyte ratio(NLR)and platelet lymphocyte ratio(PLR)with radiotherapy(RT)efficacy and prognosis in patients with esophageal squamous cell carcinoma(ESCC).Methods: The clinical data of 159 ESCC patients(?~? stage)who received RT alone or concurrent chemoradiotherapy and 40 healthy peoples(control group)were retrospectively analyzed.Based on the cut-off value of NLR=2.6 and PLR=143.1,ESCC patients were divided into different groups.Chi square test was used to compare the clinicopathological characteristics and RT efficacy between different groups.The Perason correlation analyzed was used to determine the significance between NLR and PLR.Log-rank and Cox risk model test were used to compare and survival between different groups.Survival of each groups were analyzed grouped by lymph node metastasis.Receiver operating characteristic(ROC)curves for RT efficacy and survival prediction were plotted to verify the accuracy of NLR and PLR.Results: 1.Compared to the control group,the level of NLR and PLR in ESCC patients were significantly higher(P<0.001).2.NLR and PLR showed a significant positive correlation(r=0.596,P<0.001).3.There are no associations between clinicopathological characteristics with different groups(all P>0.05).4.The RT efficacy of high NLR group was lower than the low group(79%vs95%,P=0.004).Similarly,the RT efficacy of high PLR group was lower than the low group(80%vs94%,P=0.011).5.The overall survival(OS)of the low NLR group and the high NLR group were 53.2% and 39%(?2=6.540,P=0.011),whereas the OS of the low PLR group and the high PLR group were 57% and 35% individually(?2=12.349,P=0.000.6.We also found that PLR could be used to divide patients with lymph node metastasis or not into a high and low risk groups.7.ESCC patients were grouped by RT efficacy and survival.The level of NLR and PLR in different groups were different(all P<0.05).8.Univariate analysis showed that age,simple treatment,N stage,NLR and PLR are associated with survival(all P<0.05);Multivariate analysis showed only N stage and PLR were independent prognostic factors(all P<0.05).9.The area under roc curve(AUC)plotted by curative effect of RT was 0.768 for NLR and 0.701 for PLR and AUC plotted by OS was 0.616 for NLR and 0.596 for PLR respectively(all P<0.05),indicating that NLR and PLR could be used to predicate RT efficacy and survival.Conclusion: NLR?2.6,PLR?143.1 may be convenient biomarkers to predicate with a poor RT efficacy and survival in ESCC patients.PLR could be used as an indicator to predict RT efficacy and survival prognosis in ESCC patients.