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Neutrophil-Lymphocyte Ratio as a Marker of Progression from Non-Dysplastic Barrett's Esophagus to Esophageal Adenocarcinoma: a Cross-Sectional Retrospective Study.

中性粒细胞-淋巴细胞比值作为非发育不良 Barrett 食管进展为食管腺癌的标志物: 一项横断面回顾性研究。

  • 影响因子:2.64
  • DOI:10.1007/s11605-019-04456-x
  • 作者列表:"Campos VJ","Mazzini GS","Juchem JF","Gurski RR
  • 发表时间:2020-01-01
Abstract

BACKGROUND:Immune imbalance and inflammation have been suggested as key factors of Barrett's esophagus (BE) pathway towards adenocarcinoma. The neutrophil-lymphocyte ratio (NLR) indirectly reflects the relation between innate and adaptive immune systems and has been studied in premalignant conditions as a biomarker for cancer diagnosis. Our aim was to investigate if increasing values of NLR correlated with advancing stages of BE progression to dysplasia and neoplasia. METHODS:We retrospectively analyzed data of patients with biopsies reporting BE between 2013 and 2017 and with a complete blood count within 6 months from the endoscopy, as well as patients with esophageal adenocarcinoma (EAC). NLR was calculated as neutrophil count/lymphocyte count. Cases (n = 113) were classified as non-dysplastic BE (NDBE, n = 72), dysplastic BE (DBE, n = 11) and EAC (n = 30). RESULTS:NLR progressively increased across groups (NDBE, 1.92 ± 0.7; DBE, 2.92 ± 1.1; EAC 4.54 ± 2.9), with a significant correlation between its increasing value and the presence of dysplasia or neoplasia (r = 0.53, p  2.27 was able to diagnose EAC with 80% sensitivity and 71% specificity (area under the curve = 0.8). CONCLUSION:NLR correlates with advancing stages of BE progression, a finding that reinforces the role of immune imbalance in EAC carcinogenesis and suggests a possible use of this marker for risk stratification on surveillance strategies.

摘要

背景: 免疫失衡和炎症已被认为是 Barrett 食管 (BE) 途径向腺癌发展的关键因素。中性粒细胞-淋巴细胞比值 (NLR) 间接反映了固有免疫系统和适应性免疫系统之间的关系,已在癌前状态下作为癌症诊断的生物标志物进行了研究。我们的目的是研究 NLR 的升高值是否与 BE 进展至异型增生和肿瘤的进展阶段相关。 方法: 我们回顾性分析了 2017 和 2013年活检报告且内镜检查 6 个月内有全血细胞计数的患者以及食管腺癌 (EAC) 患者的资料。NLR 计算为中性粒细胞计数/淋巴细胞计数。病例 (n = 113) 分为非发育不良 BE (NDBE,n = 72) 、发育不良 BE (DBE,n = 11) 和 EAC (n = 30)。 结果: NLR 跨组逐渐增加 (NDBE,1.92 ± 0.7; DBE,2.92 ± 1.1; EAC 4.54 ± 2.9), 其增加值与异型增生或肿瘤的存在显著相关 (r = 0.53, p   2.27 能够以 80% 的敏感性和 71% 的特异性 (曲线下面积 = 0.8) 诊断 EAC。 结论: NLR 与 BE 进展的进展阶段相关,这一发现加强了免疫失衡在 EAC 癌变中的作用,并提示可能使用该标志物对监测策略进行危险分层。

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翻译标题与摘要 下载文献
影响因子:2.64
发表时间:2020-01-01
DOI:10.1007/s11605-019-04456-x
作者列表:["Campos VJ","Mazzini GS","Juchem JF","Gurski RR"]

METHODS:BACKGROUND:Immune imbalance and inflammation have been suggested as key factors of Barrett's esophagus (BE) pathway towards adenocarcinoma. The neutrophil-lymphocyte ratio (NLR) indirectly reflects the relation between innate and adaptive immune systems and has been studied in premalignant conditions as a biomarker for cancer diagnosis. Our aim was to investigate if increasing values of NLR correlated with advancing stages of BE progression to dysplasia and neoplasia. METHODS:We retrospectively analyzed data of patients with biopsies reporting BE between 2013 and 2017 and with a complete blood count within 6 months from the endoscopy, as well as patients with esophageal adenocarcinoma (EAC). NLR was calculated as neutrophil count/lymphocyte count. Cases (n = 113) were classified as non-dysplastic BE (NDBE, n = 72), dysplastic BE (DBE, n = 11) and EAC (n = 30). RESULTS:NLR progressively increased across groups (NDBE, 1.92 ± 0.7; DBE, 2.92 ± 1.1; EAC 4.54 ± 2.9), with a significant correlation between its increasing value and the presence of dysplasia or neoplasia (r = 0.53, p  2.27 was able to diagnose EAC with 80% sensitivity and 71% specificity (area under the curve = 0.8). CONCLUSION:NLR correlates with advancing stages of BE progression, a finding that reinforces the role of immune imbalance in EAC carcinogenesis and suggests a possible use of this marker for risk stratification on surveillance strategies.

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