新辅助放化疗期间外周血白蛋白值对局晚期食管鳞癌患者预后预测的价值

目的:探讨新辅助放化疗期间外周血营养指标对局晚期食管鳞癌（esophageal squamous cell carcinoma,ESCC）患者预后的影响。方法:回顾性分析2011年11月至2020年05月我院放疗科的69例局晚期食管鳞癌新辅助放化疗患者的临床资料，采用logistic回归分析研究与pCR相关的因素，采用Cox比例风险模型进行预后生存分析，采用Kaplan-Meier法绘制各因素的生存曲线。结果:单因素logistic回归分析显示饮酒史、临床N分级、放化疗期间白蛋白值最低值与患者pCR相关（P＜0.05）；多因素logistic回归分析显示,临床N分级、放化疗期间白蛋白值最低值是影响局晚期食管鳞癌患者pCR的独立因素(P＜0.05)；Cox比例风险模型显示，新辅助放化疗期间白蛋白值最低值为局晚期食管鳞癌患者OS的预后影响因素（P=0.040，95%CI:0.171~0.959）；K-M生存分析显示，新辅助放化疗期间白蛋白值最低值≥37.35 g/L组的生存率优于白蛋白值最低值＜37.35 g/L组，差异有统计学意义（P=0.033）。结论:新辅助放化疗期间白蛋白值最低值是局晚期食管鳞癌患者术后pCR的独立预后因素，同时也是OS的预后影响因素。

Value of peripheral blood albumin value during neoadjuvant chemoradiotherapy in predicting prognosis of patients with locally advanced esophageal squamous cell carcinoma

Objective:To investigate the effect of peripheral blood nutritional indicators on the prognosis of patients with locally advanced esophageal squamous cell carcinoma（ESCC）during neoadjuvant chemoradiotherapy.Methods:The clinical data of 69 patients with locally advanced ESCC treated with neoadjuvant chemoradiotherapy in our hospital from November 2011 to May 2020 were analyzed retrospectively.The indicators were studied by logistic regression analysis for the factors related to pCR.Cox proportional hazard model was used to analyze the prognosis and survival.Kaplan Meier method was used to draw the survival curves of various factors.Results:Univariate logistic regression analysis showed that drinking history,N stage and the albumin nadir during chemoradiotherapy were correlated with pCR(P＜0.05).Multivariate logistic regression analysis showed that N stage and the albumin nadir during chemoradiotherapy were independent factors affecting pCR in patients with locally advanced ESCC(P＜0.05).Cox proportional hazard model showed that the albumin nadir during neoadjuvant chemoradiotherapy was the prognostic factor of OS in patients with locally advanced ESCC（P=0.040，95%CI:0.171~0.959）.K-M survival analysis showed that the survival rate of the group with the albumin nadir during neoadjuvant chemoradiotherapy≥ 37.35 g/L was better than that of the group with the albumin naidr<37.35 g/L（P=0.033）.Conclusion:The albumin nadir during neoadjuvant chemoradiotherapy is an independent prognostic factor for postoperative pCR in patients with locally advanced ESCC and also a prognostic factor of OS.