ABSTRACT
Objective:To explore the predictive values of preoperative peripheral blood lymphocyte-to-monocyte ratio (LMR) and platelet-to-lymphocyte ratio (PLR) in early postoperative recurrence of patients with esophageal squamous cell carcinoma.Methods:A total of 83 patients with esophageal squamous cell carcinoma who underwent radical surgery in the First Affiliated Hospital of Nanjing Medical University from November 2015 to December 2018 were collected. Patients were divided into recurrent group ( n=41) and control group ( n=42) according to the recurrence within 1 year. The levels of LMR and PLR before operation were detected by automatic blood analyzer, and the differences of LMR and PLR between the two groups were compared. The values of LMR, PLR and the combination of LMR and PLR in predicting early postoperative recurrence of esophageal squamous cell carcinoma were analyzed by receiver operating characteristic (ROC) curve. Results:Compared with the control group, the recurrence group had smaller LMR (3.91±1.73 vs. 5.08±2.15; t=2.710, P=0.008), larger PLR (142.81±67.80 vs. 114.03±42.47; t=2.324, P=0.023), larger tumor diameter [(4.28±1.61) cm vs.(3.19±1.30) cm; t=3.420, P=0.001], deeper infiltration ( Z=2.633, P=0.008) and later clinical stage ( Z=2.616, P=0.009), with statistically significant differences. The sensitivity and specificity of LMR in predicting recurrence of esophageal cancer after surgery were 69.0% and 58.5% respectively, with the area under the curve of 0.666 (95% CI: 0.551-0.782, P=0.009) and a critical value of 4.12. The sensitivity and specificity of PLR in predicting recurrence of esophageal cancer after surgery were 51.2% and 78.6% respectively, with the area under the curve of 0.642 (95% CI: 0.522-0.761, P=0.026) and a critical value of 130.85. The sensitivity and specificity of LMR combined with PLR were 68.3% and 61.9% respectively, and area under the curve of ROC was 0.675 (95% CI: 0.560-0.791, P=0.006). Patients with low LMR and high PLR had higher risk of recurrence rate [81.0%(17/21)] than those with high LMR and low PLR [35.1%(13/37)], and the difference was statistically significant ( P=0.001). Conclusion:Preoperative LMR and PLR are effective indicators for early postoperative recurrence in patients with esophageal squamous cell carcinoma, and the combination of LMR and PLR has a higher predictive value.
ABSTRACT
Background and purpose:At present, the relationship between tumor length and prognosis of esophageal carcinoma patients has been a controversial topic, and there have been few studies describing the effect of tumor length on clinicopathology and prognosis of node-negative esophageal carcinoma patients. The purpose of this study was to investigate the effect of the tumor length on clinicopathology and prognosis of node-negative esophageal carcinoma patients.Methods:The clinicopathological characteristics and survival time of 686 node-negative esophageal carcinoma patients, conifrmed by surgical pathology specimens in the First Afifliated Hospital of Nanjing Medical University from Jan. 2008 to Dec. 2010, were retrospectively analyzed. The optimal cut-off value was determined by decision tree model. Univariate and multivariate methods were used to analyze the prognostic factors of node-negative esophageal carcinoma patients.Results:In decision tree analysis, esophageal tumor length was correlated with an increasing hazard ratio for death with a cut-off value at 3 cm. No signiifcant differences were found in gender, onset age, lesion site and pathological type between 2 groups which were patients with tumor length≤3 cm and tumor length >3 cm (P>0.05). The only 1 difference between 2 groups was T stage (P3 cm were 95.7%, 84.4%, 76.1% and 88.3%, 57.8%, 46.5% respectively, and the difference was statistically signiifcant (P3 cm as T3. Tumor length is an important prognostic factor for esophageal carcinoma patients without lymphatic metastasis.
ABSTRACT
In recent years,the bone marrow micrometastasis of esophageal cancer has become the research focus.Many studies show that epithelial cell molecules,angiogenesis markers,chemokine receptor-4 (CXCR-4),HER2,activated leukocyte cell adhesion molecule (ALCAM) and stanniocalcin-1 (STC-1) are closely related to the bone marrow micrometastasis of esophageal cancer.These molecular markers play important roles in esophageal cancer diagnosis,prognosis and treatment.