Relationship between NLR and esophageal stenosis after ESD operation and ≥3/4 circumferential esophageal cancer
10.3760/cma.j.cn431274-20231128-00610
- VernacularTitle:NLR与病变≥3/4环周食管早癌及癌前病变ESD术后食管狭窄的关系
- Author:
Hui HUANG
1
;
Shengbao LI
Author Information
1. 十堰市太和医院（湖北医药学院附属医院）消化内科，十堰 442000
- Keywords:
Esophageal neoplasms;
Neutrophils;
Lymphocytes;
Endoscopic submucosal resection;
Esophageal stenosis
- From:
Journal of Chinese Physician
2024;26(11):1695-1699
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To analyze the related factors of esophageal stenosis after endoscopic mucosal dissection (ESD) for patients with ≥3/4 annular esophageal early cancer and precancerous lesions, and to evaluate the relationship between neutrophil to lymphocyte ratio (NLR) and esophageal stenosis after ESD.Methods:Data of patients with ≥3/4 circumference-based early esophageal cancer and precancerous lesions after ESD operation in Shiyan Taihe Hospital from January 2017 to December 2021 were collected. Patients were divided into stenosis group and no-stenosis group according to whether esophageal stenosis occurred after ESD operation. Clinical data of the two groups were compared. Neutrophil count (NEU), lymphocyte count (LYM) and NLR were different in peripheral blood and cancer tissue.Results:Of 40 patients, 11 (27.5%) were in the stenosis group. There were 29 cases (72.5%) without stenosis. The proportion of lesions in the stenosis group was higher than that in the no-stenosis group, with the depth of infiltration greater than M2 and the longitudinal length ≥5 cm, and the difference was statistically significant (all P<0.05). There were no significant differences in NEU, LYM and NLR in peripheral blood between the two groups before and the first day after surgery (all P>0.05). On the 3rd day after surgery, peripheral blood NEU and NLR in the stenosis group were higher than those in the no-stenosis group, and LYM was lower than that in the no-stenosis group, with statistical significance (all P<0.05). There were significant differences in NEU, LYM and NLR in cancer tissue between the two groups (all P<0.01). Lesion location ( OR=27.827, 95% CI: 1.53-506.60, P=0.025), depth of lesion invasion ( OR=0.032, 95% CI: 0.001-0.705, P=0.029), longitudinal length of lesion ( OR=0.048, 95% CI: 0.003-0.757, P=0.031) and cancer tissue NLR ( OR=5.435, 95% CI: 8.825E+ 10-3.348E+ 302, P=0.035) are independent risk factors for postoperative stenosis of ≥3/4 circle ESD. Conclusions:Systemic inflammation caused by ESD surgery and local inflammation of preoperative lesions are important factors in the formation of esophageal stenosis after ≥3/4 ring ESD surgery. Preoperative anti-inflammatory therapy and enhancement of postoperative anti-inflammatory intensity may be important strategies to prevent esophageal stenosis.
