食管鳞状细胞癌化放疗术后术前中性粒细胞与淋巴细胞比率与根治性食管切除术后肺部并发症有关。

IF 2 3区 医学 Q2 ANESTHESIOLOGY
Chien-Ming Lo, Hung-I Lu, Yu-Ming Wang, Yen-Hao Chen, Yu Chen, Li-Chun Chen, Shau-Hsuan Li
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引用次数: 0

摘要

目的:化放疗后食管切除术与手术并发症风险增加有关。术前中性粒细胞与淋巴细胞比值以及化放疗后血小板与淋巴细胞比值对预测术前接受化放疗的食管鳞癌患者根治性食管切除术后肺部并发症的意义尚不清楚。我们旨在研究中性粒细胞与淋巴细胞比值和血小板与淋巴细胞比值在预测术前化疗后食管切除术肺部并发症中的作用:我们回顾性研究了2009年1月至2017年12月期间连续接受术前化疗放疗后食管切除术的111例III期食管鳞癌患者。手术前收集了实验室数据,并记录了手术结果和并发症。我们计算了中性粒细胞与淋巴细胞比率和血小板与淋巴细胞比率,并将其与临床指标、术后并发症、总生存率和无病生存率相关联:75例(68%)患者出现术后并发症,其中32例(29%)出现肺部并发症。术前中性粒细胞与淋巴细胞比值≥3(P = 0.008)、临床 T4 分级(P = 0.007)和晚期 IIIC 期(P = 0.012)与肺部并发症显著相关。术前中性粒细胞与淋巴细胞比值为结论的患者肺部并发症发生率分别为15%和38%:化放疗后术前中性粒细胞与淋巴细胞比值升高与根治性食管切除术后肺部并发症发生率升高以及术前接受化放疗的食管鳞状细胞癌患者预后不良密切相关。术前中性粒细胞与淋巴细胞比值是临床实践中的常规指标,我们的研究结果表明,它可作为术前接受化放疗的食管鳞癌患者食管切除术后肺部并发症的预测指标。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Preoperative neutrophil-to-lymphocyte ratio after chemoradiotherapy for esophageal squamous cell carcinoma associates with postoperative pulmonary complications following radical esophagectomy.

Objectives: Esophagectomy after chemoradiotherapy is associated with an increased risk of surgical complications. The significance of preoperative neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio after chemoradiotherapy in predicting pulmonary complications following radical esophagectomy in esophageal squamous cell carcinoma patients receiving preoperative chemoradiotherapy remains unknown. We aimed to investigate the utility of neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio in predicting the pulmonary complications of esophagectomy after preoperative chemoradiotherapy.

Methods: We retrospectively reviewed 111 consecutive patients with stage III esophageal squamous cell carcinoma who received preoperative chemoradiotherapy followed by esophagectomy between January 2009 and December 2017. Laboratory data were collected before the operation and surgical outcomes and complications were recorded. We calculated neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio and correlated them with the clinical parameters, postoperative complications, overall survival, and disease-free survival.

Results: Postoperative complications were observed in 75 (68%) patients, including 32 (29%) with pulmonary complications. The preoperative neutrophil-to-lymphocyte ratio of ≥ 3 (P = 0.008), clinical T4 classification (P = 0.007), and advanced stage IIIC (P = 0.012) were significantly associated with pulmonary complications. Pulmonary complication rates were 15% and 38% in patients with preoperative neutrophil-to-lymphocyte ratio of < 3 and ≥ 3, respectively. Preoperative neutrophil-to-lymphocyte ratio was not associated with the oncological stratification such as pathological T classification, pathological N classification, and pathological AJCC stage. The 3-year overall survival rates were 70% and 34% in patients with preoperative neutrophil-to-lymphocyte ratio of < 3 and ≥ 3, respectively (P = 0.0026). The 3-year disease-free survival rates were 57% and 29% in patients with preoperative neutrophil-to-lymphocyte ratio of < 3 and ≥ 3, respectively (P = 0.0055). The preoperative neutrophil-to-lymphocyte ratio of ≥ 3 was independently associated with more pulmonary complications, inferior overall survival, and worse disease-free survival.

Conclusions: Elevated preoperative neutrophil-to-lymphocyte ratio after chemoradiotherapy is independently associated with higher pulmonary complication rate following radical esophagectomy and poor prognosis in patients with esophageal squamous cell carcinoma receiving preoperative chemoradiotherapy. Preoperative neutrophil-to-lymphocyte ratio is routinely available in clinical practice and our findings suggest it can be used as a predictor for pulmonary complications after esophagectomy in patients with esophageal squamous cell carcinoma receiving preoperative chemoradiotherapy.

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