中性粒细胞和血小板与淋巴细胞比值对食管鳞癌临床病理特征及预后的意义

目的：探讨中性粒细胞/淋巴细胞比值（NLR）、血小板/淋巴细胞比值（PLR）与食管鳞癌临床病理特征及手术预后的关系，为食管鳞癌的临床治疗提供参考。方法：回顾性分析河北医科大学第四医院2010年1月1日—2013年12月31日收治的食管鳞癌手术患者，共134例。分析NLR、PLR与食管鳞癌临床病理特征及手术预后的关系。结果：低NLR （< 2.34）组患者T分期早于高NLR （≥2.34）组患者（P=0.001）；低PLR （< 152.76）组患者T分期早于高PLR （≥152.76）组患者（P < 0.01）。低NLR （< 2.12）组患者病变长度小于高NLR （≥2.12）组患者（P < 0.01）；低PLR （< 103.91）组患者病变长度小于高PLR （≥103.91）组患者（P < 0.01）。全组患者1、3、5年生存率分别为88.1%、45.8%、33.9%，局部控制率分别为88.0%，69.0%，67.4%，1、3、5年远处转移率分别为27.6%、54.9%、55.9%；其中高NLR组患者1、3、5年远处转移率显著高于低NLR组（P=0.012），高PLR组患者1、3、5年远处转移率显著高于低PLR组（P=0.014）。多因素分析显示仅N分期是患者生存的独立影响因素（P=0.014）。结论：NLR、PLR与食管癌患者的临床病理特征和预后密切相关，高NLR和高PLR的患者T分期较晚，病变长度较长，且更易出现远处转移。

Relationships among blood cell ratios,clinicopathological characteristics and prognosis in esophageal squamous cell carcinoma

OBJECTIVE： To investigate relationships among neutrophil-lymphocyte ratio (NLR)，plateletlymphocyte ratio (PLR)， clinicopathological characteristics and prognosis of esophageal squamous cell carcinoma. METHODS： Retrospective analyses were conducted on 134 patients who had surgery for esophageal squamous cell carcinoma from January 1， 2010 to December 31， 2013. Relationships among NLR， PLR， clinicopathological characteristics and prognosis of these carcinomas were evaluated. RESULTS： The T stage of patients in the low NLR (<2.34) group was significantly earlier than those in the high NLR (≥ 2.34) group (P=0.001). The T stage of patients in the low PLR (<152.76) group was also significantly earlier than those in the high PLR (≥152.76) group (P < 0.01). The lesion length of patients in the low NLR (<2.12) group was significantly shorter than that in the high NLR (≥2.12) group (P < 0.01). Patients with low PLR (< 103.91) were also significantly shorter than those with high PLR (≥103.91) (P < 0.01). The 1，3，and 5 year survival rates and local control rates of the entire group were 88.1%，45.8%，33.9%，and 88.0%，69.0%， 67.4%，respectively. The 1，3，and 5 years of the transfer rates were 27.6%，54.9%，55.9%. The 1-，3-， and 5-year remote turnout rates of patients in the high NLR group were much higher than those in the low NLR group (P=0.012). The 1-，3-，and 5-year long-term turnout rates of patients in the high PLR group were much higher than those in the low PLR group (P=0.014). Multivariate analyses of survival show that only the N stage was an independent factor affecting the survival of patients (P=0.014). CONCLUSION： NLR and PLR are closely related to the clinicopathological characteristics and prognosis of patients. Patients with high NLR and high PLR had late T stage，longer lesion length and are more prone to distant metastasis.