| Objective To evaluate the prognostic significance of the peripheral blood neutrophil-to-lymphocyte ratio(NLR)in patients with post-operative recurrent esophageal squamous cell carcinoma.The purpose of this study is to provide more effective individualized treatment strategies and to provide a reference for the evaluation of prognosis.Method Retrospective study was used to analysis the clinical data of 108 patients with recurrent and complete follow-up data after radical esophagectomy during January 2013 to January 2017 in the Department of radiotherapy at the First Affiliated Hospital of Fujian Medical University.By establishing receiver operator characteristic(ROC)curves,the best cut-off point for NLR prediction of survival after recurrence was calculated and determined.The patients were divided into two groups: NLR group with low recurrence and NLR group with high recurrence,the survival rates of two groups for one year and two years after recurrence was compared.Stratified analysis was carried out according to age,sex,tumor site,postoperative TNM stage,the number of cleared lymph nodes,the degree of tumor differentiation,the absence of vascular tumor thrombus,the recurrent location,the recurrent time interval and treatment plan after relapse.Result According to the ROC curve of peripheral blood NLR at the time of recurrence,the best cut-off point of NLR was determined to be 2.75.Analysis of clinical case characteristics shows that the degree of tumor differentiation,postoperative TNM stage,presence or absence of vascular tumor thrombus in low recurrence NLR group(NLR < 2.75,66 cases)and high recurrence NLR group(NLR ≥ 2.75,42 cases)were significantly different(all P< 0.05).Single factor analysis shows that,age < 60 years old,postoperative TNM stage for Ⅲperiod,anastomotic stoma combined with supraclavicular lymph node recurrence and NLR≥2.75 group were the risk factors which would influence the survival in patients with recurrence(all P< 0.05).The postoperative recurrence rate of patients with recurrent esophageal squamous cell carcinoma at different recurrence sites was statistically significant(P < 0.001).In the lower NLR group,1 year survival rate and 2 years survival rates after recurrence were 81.8% and 27.3% respectively.But in the higher NLR group,1 year survival rate and 2 years survival rates after recurrence were 28.6% and 4.8% respectively.The difference between two groups was statistically significant(P < 0.001).Cox multivariate analysis results shows that,age < 60 years old,postoperative TNM stage for Ⅲperiod and NLR≥2.75 after recurrent were independent factors affecting the prognosis of patients with recurrence(all P< 0.05).Conclusion There were significant differences in tumor differentiation,postoperative TNM stage and presence or absence of vascular tumor thrombus between low NLR recurrence group and high NLR recurrence group.There was a significant difference in the survival rate of patients with recurrent esophageal squamous cell carcinoma at different recurrence sites.Age < 60 years old,postoperative TNM staging for period,Ⅲanastomotic stoma combined with supraclavicular lymph node recurrence and NLR≥2.75 group,all of these were the risk factors which would influence the survival in patients with postoperative recurrence of esophageal squamous cell carcinomas,including age < 60 years old,postoperative TNM stage for Ⅲperiod and NLR≥2.75 group were the independent factors affecting the prognosis of patients with the tumor recurrence.The survival rate of patients who with postoperative recurrence esophageal squamous cell carcinomas with high NLR group after recurrence was significantly lower than that in the lower NLR group in 1 year survival rate and 2 years survival rates after recurrence.The peripheral blood NLR ≥ 2.75 indicates that the prognosis of patients with recurrent esophageal squamous cell carcinoma is poor and it is an independent risk factor for survival of patients with recurrent esophageal squamous cell carcinoma. |
PDF Full Text Request