| Objective:By discussing the relationship between the neutrophil-to-lymphocyte ratio(NLR)before and after surgery and the change rate before and after surgery and studying the clinical characteristics,to search the independent factor on the prognosis of patients with esophageal cancer to provide a simple predictor for the prognosis of postoperative esophageal cancer patientsMethods:In this study,the clinical information of esophageal cancer patients who underwent radical surgery for esophageal cancer in Qilu Hospital in 2016 were collected,including basic clinical data on tobacco and alcohol history,postoperative pathological staging and other tumor-related data.Hematological data such as the absolute value of lymphocytes and neutrophils before and after surgery,as well as postoperative treatment data such as postoperative complications,postoperative anti-tumor therapy,and we got the survival data of patients by websites and telephone.The relationship between preoperative NLR and the clinical characteristics except survival data was retrospectively analyzed,and on this basis,the receiver operating characteristic(ROC)curve was drawn by learning the correlation between NLR and survival data,respectively.To determine the preoperative NLR,postoperative NLR,and preoperative and postoperative NLR rate of change(ΔNLR)cut-off values that can affect patient survival after surgery.To study the correlation of NLR and its rate of change in different groups with clinical characteristics other than survival data.After proving and excluding the influence of irrelevant clinical treatment on NLR,Kaplan-Meier method is used to make an univariate survival analysis and Cox multivariate analysis on the clinical data and survival data of the patients,and then search for valuable indicators for the prognosis of patients.In this study,SPSS 23.0 is used to analyze the data,and P<0.05 means that the difference is statistically significant.Results:Gender(P=0.443),age(P=0.541),smoking history(P=0.231),nutritional score(P=0.790),primary tumor site(P=0.762),pathological type(P=0.786),T stage(P=0.170),N stage(P=0.414),pathological grade(P=0.867),postoperative pathological stage(P=0.199),postoperative complications(P=0.405)and postoperative anti-tumor therapy(P=0.520)and other clinical characteristics,there was no relationship between NLR and these clinical features of esophageal cancer.However,there was a difference when one had a drinking history,(P=0.001).Based on Kaplan-Meier method,univariate survival analysis was used to relevant data,smoking history(P=0.015),drinking history(P=0.001),pathological type(P=0.042),postoperative pathological stage(P=0.025),postoperative Antitumor therapy(P=0.049),preoperative NLR(P=0.044),postoperative NLR(P=0.043),and the ANLR(P=0.014)were closely related to patients’ overall survival(OS).Smoking history(P=0.039),drinking history(P=0.001),pathological type(P=0.030),postoperative NLR(P=0.047),andΔNLR(P=0.012)were associated with progression-free progression in patients with esophageal cancer.These who had a positive result(P<0.05),would be had the Cox multivariate analysis,and the result showed that drinking history(P=0.005),pathological type(P=0.001/0.002),postoperative pathological stage(P=0.005)=0.010/0.035/0.005),postoperative anti-tumor therapy(P=0.031),ΔNLR(P=0.039)were all independent factors affecting postoperative OS.Drinking history(P=0.006),pathological type(P=0.011/0.014),and NLR change rate before and after surgery(P=0.048)were independent factors affecting postoperative PFS.Conclusion:Drinking is allied to the preoperative NLR in esophageal cancer patients after surgery closely.For patients with esophageal cancer,ΔNLR is an independent factor,and a high rate of change indicates a worse prognosis.The OS and PFS of esophageal cancer patients with high postoperative NLR and big ΔNLR were shorter.The rate of change before and after NLR surgery can be used as an indicator to predict the prognosis of patients with esophageal cancer after surgery. |
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