Combined neutrophil-platelet score and hemoglobin level predict survival in esophageal squamous cell carcinoma patients treated with chemoradiotherapy

Chuanwang Miao; Shan Zhu; Hong Pan; Xiaolan Cao; Shuanghu Yuan; Xudong Hu

doi:10.18632/oncotarget.21313

Combined neutrophil-platelet score and hemoglobin level predict survival in esophageal squamous cell carcinoma patients treated with chemoradiotherapy

Oncotarget. 2017 Sep 27;8(50):87971-87979. doi: 10.18632/oncotarget.21313. eCollection 2017 Oct 20.

Authors

Chuanwang Miao^#^{1

2}, Shan Zhu^#^{3

4}, Hong Pan⁵, Xiaolan Cao^{1

2}, Shuanghu Yuan², Xudong Hu²

Affiliations

¹ School of Medicine and Life Sciences, University of Jinan-Shandong Academy of Medical Sciences, Jinan, Shandong Province, P.R. China.
² Department of Radiotherapy, Shandong Cancer Hospital Affiliated to Shandong University, Jinan, Shandong Province, P.R. China.
³ Department of Head and Neck Radiotherapy, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, Shandong Province, P.R. China.
⁴ Department of Head and Neck Radiotherapy, Shandong Provincial Western Hospital, Jinan, Shandong Province, P.R. China.
⁵ Central Sterile Supply Department, Shandong Cancer Hospital Affiliated to Shandong University, Jinan, Shandong Province, P.R. China.

^# Contributed equally.

Abstract

Systemic inflammation and hematological markers have prognostic value in patients with esophageal squamous cell carcinoma (ESCC). The objective of this study was to evaluate the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), combined neutrophil-platelet (CNP) score, and hemoglobin (Hb) to inform treatment decisions and predict outcomes in patients with locally advanced ESCC treated with chemoradiotherapy (CRT). A total of 168 patients with locally advanced ESCC were retrospectively evaluated. Patients were stratified by marker value using a receiver operating characteristic curve analysis to determine the cutoff point. Logistic regression was used to identify markers associated with sensitivity to treatment. Overall survival (OS) was calculated by the Kaplan-Meier method. Multivariate Cox logistic regression modeling was used to assess the influences of OS. Smoking history, tumour site, clinical stage, NLR, PLR, CNP, and Hb (p ≤ 0.05) were associated with the sensitivity to therapy. In multivariate analysis, a high CNP score was independently associated with poor treatment sensitivity (OR = 2.066, p = 0.021). Univariate analysis revealed that PLR, CNP, and Hb levels were associated with OS, and Cox multivariate analysis found that CNP (HR = 1.47, p = 0.027) and Hb level (HR = 0.44, p = 0.007) were independent predictors of OS. In conclusion, CNP and Hb are inexpensive and universally available prognostic markers in patients with locally advanced ESCC patients. CNP score is a systemic inflammatory marker that predicted sensitivity to CRT.

Keywords: chemoradiotherapy (CRT); esophageal squamous cell carcinoma (ESCC); hemoglobin (Hb); neutrophil-to-lymphocyte ratio (NLR); platelet-to-lymphocyte ratio (PLR).