Application Of Neutrolphil-lymphocyte Ratio And Prognostic Nutrition Index In Prognosis Of Patients With Esophageal Squamous Cell Carcinoma

Objective To explore whether the preoperative neutrophil-lymphocyte ratio(NLR)and prognostic nutritional index(PNI)can be used as effective prognostic predictors in patients with esophageal squamous cell carcinoma.Methods 118 cases of esophageal squamous cell carcinoma,diagnosed by the thoracic surgery department of First Affiliated Hospital of Anhui Medical University were analyzed retrospectively,and 103 cases were followed up with a follow-up rate of87.28%.According to one week before surgery and peripheral blood routine test and biochemical test results,all these patients were divided into low NLR group(NLR <2.21,n=51)and high NLR group(NLR?2.21,n=52),low PNI group(PNI < 44.56,n=40)and high PNI group(PNI?44.56,n=63).The related prognostic factors such as NLR,PNI,sex,age,tumor size,tumor location,TNM classification and degree of histological differentiation were analyzed.The survival rate was calculated by Kaplan-Meier analysis,the difference between groups were compared using Log-rank test.Cox proportional hazard regression model was used to analyze the factors which may affect the prognosis of the patients.Results The results of univariate analysis showed that tumor size(HR,0.306;95%CI0.140-0.668;P=0.003),differentiation(HR,0.594;95%CI 0.373-0.948;P=0.029),TNM classification(HR,0.317;95%CI 0.194-0.517;P < 0.001),NLR(HR,0.294;95%CI0.182-0.474;P< 0.001)and PNI(HR,2.887;95%CI 1.821-4.576;P < 0.001)level of prognosis,the differences were statistically significant(P?0.05).Multivariate analysis found that NLR(HR,0.562;95%CI 0.324-0.975;P=0.04),PNI(HR,1.877;95%CI1.125-3.129;P=0.016)and TNM stage(HR,0.444;95%CI 0.262-0.753;P=0.003)are independent prognostic factors in patients with esophageal squamous cell carcinoma,NLR ?2.21 and / or PNI <44.56 predicted shorter survival in esophageal cancer patients.Conclusion Both NLR and PNI can predict the prognosis of patients with esophageal squamous cell carcinoma better,which are simple and effective index for preoperative evaluation and prognostic analysis.