食管鳞癌患者新辅助治疗后的中性粒细胞/淋巴细胞比值与病理反应的相关性  

Correlation between neutrophil-lymphocyte ratio and pathological response after neoadjuvant treatment for patients with esophageal squamous cell carcinoma

作　　者：谢晓彤 刘婧禹 马壬杰 闫明玥 羊艳艳 湛先保 彭小波 XIE Xiaotong;LIU Jingyu;MA Renjie;YAN Mingyue;YANG Yanyan;ZHAN Xianbao;PENG Xiaobo(Department of Oncology,the First Affiliated Hospital of Naval Medical University,Shanghai 200082,China)

机构地区：[1]海军军医大学第一附属医院肿瘤科,上海200082

出　　处：《临床肿瘤学杂志》2025年第2期138-142,共5页Chinese Clinical Oncology

基　　金：海军军医大学第一附属医院基础医学研究专项(2023PY29)。

摘　　要：目的探讨食管鳞状细胞癌患者新辅助治疗后的中性粒细胞与淋巴细胞比值(NLR)与病理反应的相关性。方法回顾性分析海军军医大学第一附属医院67例接受新辅助治疗联合食管癌根治术患者的临床病理资料。使用受试者工作特征(ROC)曲线计算NLR的最佳临界值,评价NLR与食管鳞癌临床病理特征的相关性;根据肿瘤退缩分级(TRG),将TRG 0级、TRG 1级和TRG 2级的患者归为有反应组,TRG 3级的患者被归为无反应组,分析NLR以及其他临床病理参数与肿瘤退缩程度的相关性。采用Logistic回归模型分析影响食管鳞癌患者新辅助治疗后病理反应的因素。结果经ROC曲线获得NLR的最佳临界值为1.945,由此将患者分为NLR低水平组(<1.945)和NLR高水平组(≥1.945)。与NLR高水平组比较,NLR低水平组中病理T分期或N分期低的患者占比更大,差异有统计学意义(P<0.05)。单因素分析结果显示,新辅助治疗后有反应组和无反应组在年龄、病理T分期、病理N分期以及NLR水平进行比较,差异均有统计学意义(P<0.05);多因素Logistic回归分析结果显示,病理T分期、病理N分期及NLR是影响新辅助治疗后病理反应的因素(P<0.05)。结论在食管鳞状细胞癌的患者中,新辅助治疗后的NLR是预测病理反应有效的标志物。Objective To explore the correlation between neutrophil-lymphocyte ratio(NLR)and pathological response to neoadjuvant therapy in patients with esophageal squamous cell carcinoma.Methods The clinicopathological features of 67 patients accepting neoadjuvant therapy combined with radical surgery for esophageal squamous cell carcinoma in the First Affiliated Hospital of Naval Medical University were retrospectively analyzed.The receiver operating characteristic(ROC)curve was used to calculate the optimal threshold value of NLR,and evaluate the correlation between NLR and clinicopathological characteristics.According to the tumor regression grade(TRG),patients with TRG 0,TRG 1 and TRG 2 were classified as responders,and patients with TRG 3 were classified as the non-responders.The correlation between NLR and other clinical pathological parameters and the degree of tumor regression was analyzed.The Logistic regression model was used to analyze the factors affecting the pathological response of patients with esophageal squamous cell carcinoma after neoadjuvant therapy.Results The optimal critical value of NLR obtained by ROC curve was 1.945,and the correlation analysis between NLR and clinicopathologic characteristics showed that there were statistically significant differences in pathological T stage and pathological N stage between the low level of NLR group(<1.945)and the high level of NLR group(≥1.945).Univariate analysis showed that there were significant differences in age,pathological T stage,pathological N stage and NLR between the responders and the non-responders(P<0.05).Multifactor analysis showed that pathological T stage,pathological N stage and NLR were linked to the pathological response after neoadjuvant therapy(P<0.05).Conclusion NLR after neoadjuvant therapy is a effective marker for predicting pathological response in patients with esophageal squamous cell carcinoma.

关 键 词：食管鳞状细胞癌 新辅助治疗 肿瘤退缩分级 中性粒细胞/淋巴细胞比值 

分 类 号：R735.1[医药卫生—肿瘤]