Preoperative Systemic Inflammatory Measures as a Maker of Recurrence in Patients with Early Esophageal Squamous Cell Cancer:a Cross-Sectional Retrospective Study

Abstract Background. It is reported that systemic inflammatory measures including neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and systemic immune-inflammatory index (SII) were associated with prognosis in patients with advanced esophageal squamous cell carcinoma (ESCC),but the correlation between the prognosis of early ESCC and above parameters is still unclear. Objective. The aim of this study was to evaluate whether preoperative systemic inflammatory measures were associated with ectopic recurrence in patients with early ESCC after endoscopic submucosal dissection (ESD). Methods. Preoperative systemic inflammatory measures were obtained in 120 patients who received the treatment of ESD for early ESCC from July 2015 to September 2018. Clinicopathological characteristics were compared between recurrence and non-recurrence groups. Receiver operating characteristic (ROC) curves were plotted, and the areas under the ROC curves (AUROCs) were compared to verify the accuracy of each measure in predicting recurrence. Results. NLR and SII were significantly higher in patients suffering ectopic recurrence than non-recurrence patients (NLR, 2.38 ± 1.30 vs 3.32 ± 1.00, p = 0.016; SII, 349.79 ± 223.21 vs 511.49 ± 208.63, p = 0.029). NLR > 2.24 (90% sensitivity and 57.3%, specifically, p = 0.005, AUROC = 0.771) and SII > 345.49 (90% sensitivity and 58.2% specifically, p = 0.007, AUROC = 0.757) were predictors of recurrence . Conclusion. Patients with higher NLR and SII levels were at higher risk of ectopic recurrence. NLR and SII should be clinically useful biomarkers to guide early ESCC postoperative follow-up procedures.