The clinical significance of the relevance between host inflammatory status and prognosis has recently begun to emerge. Elevated preoperative neutrophil-to-lymphocyte ratio has been known to be associated with poor clinical outcome in many gastrointestinal tumors. The aim of this study was to investigate the prognostic value of neutrophil-to-lymphocyte ratio in patients with esophageal adenocarcinoma.
We retrospectively analyzed 114 patients with esophageal adenocarcinoma treated in our hospital between October 2008 and October 2010. NLR was calculated with the following formula: peripheral neutrophil count/lymphocyte count (109/L). Correlations of neutrophil-to-lymphocyte ratio with other clinicopathological data and prognosis were analyzed. The survival was calculated by Kaplan-Meier analysis. The differences between groups were compared using Log-rank test. Cox regression was used to analyze the factors which may affect the survival of the patients.
The survival rate was found to be related to tumor size, N stage, TNM stage, hospital stay time and NLR (P=0.000, P=0.000, P=0.000, P=0.038, P=0.000). High NLR group had significantly poorer survival than low NLR group (1-,3-,5-year survival rate 81.3% vs. 92.4%, 22.9% vs. 69.7%, 3.1% vs. 31.2%, P=0.088, P =0.000, P =0.000). Besides TNM stage (HR = 4.450, 95%CI: 2.990-6.623, P = 0.000), Neutrophil-to-lymphocyte ratio was identified as an independent prognostic factor for patients with esophageal adenocarcinoma (HR = 2.739, 95%CI: 1.687-4.446, P = 0.000). According to the sub-site stratified analysis, TNM stage and NLR were independent risk factors for both upper/middle section group and lower section group (HR = 6.983, 95%CI: 3.311-14.729, P = 0.000 and HR = 2.319, 95%CI: 1.015-5.299, P = 0.046; HR = 4.241, 95%CI: 2.557-7.035, P = 0.000 and HR = 3.192, 95%CI: 1.726-5.903, P = 0.000).
Neutrophil-to-lymphocyte ratio is a valuable clinical marker in preoperative estimation as well as prognosis prediction for patients with esophageal adenocarcinoma.
Clinical trial identification
Legal entity responsible for the study
The 4th Hospital of Hebei Medical University
Key Medical Research Programme of Hebei province, China
All authors have declared no conflicts of interest.