血液炎症指标与食管癌及癌前病变的相关性分析

The Correlation Analysis between Blood Inflammation Marker and Esophageal Cancer and Precancerous Lesions

摘要: 除内镜检查外，肿瘤标志物检测是早期发现食管癌及癌前病变的方法之一。目前，除常规消化道肿瘤标志物以外，新型生物标志物的探索仍是学界研究的重点。既往研究表明，血常规中各血细胞的构成与机体的慢性炎症状态相关。然而，血常规中各指标的变化与食管癌及癌前病变的相关性仍未完全阐明。本研究纳入自2020年1月至2024年12月于东南大学附属中大医院消化内科行胃镜检查的患者，收集患者的一般人口学资料、生活习惯、消化道肿瘤家族病史、血常规中各指标、血脂检查、肿瘤标志物、白光内镜表现、病理诊断信息等。计数资料采用均值或四分位间距进行描述，分类资料采用构成比进行描述。通过单因素及多因素回归分析各指标与食管癌及癌前病变的相关性。通过纳排标准，本研究共纳入419位患者。其平均年龄为61.50 ± 9.51岁，男性占比为65.87%。患者的吸烟和饮酒的占比分别为16.46%及14.56%。其中，正常组患者为204例，食管病变组的患者(食管癌前病变及食管癌)为215例。其中，中性粒细胞与淋巴细胞比值(Neutrophil to Lymphocyte Ratio, NLR)、单核淋巴细胞比值(Mononuclear Lymphocyte Ratio, MLR)、全身炎症标志物(Systemic Inflammation Response Index, SIRI)在病变组中显著升高；通过二元logistic回归分析结果表明，MLR、全身免疫炎症指数(Systemic Immune Inflammatory Index, SII)升高是食管病变的独立危险因素。按照性别进行亚组分析，结果同样表明，MLR及SII升高与食管病变显著相关。因此，血液中炎症指标与食管癌及癌前病变显著相关，MLR及SII升高是发生食管癌及癌前病变的危险因素。

Abstract: In addition to gastroscopy, tumor biomarker is one of the early detections of esophageal cancer and precancerous lesions. Presently, the exploration of new biomarkers still focuses on academic research. Previous studies have shown that the composition of various blood cells is related to the chronic inflammatory. However, the correlation between various indicators in blood routine and esophageal cancer and precancerous lesions has not been fully elucidated. The study aims to analyze the correlation between various inflammatory markers in blood and esophageal cancer and precancerous lesions. It included patients underwent gastroscopy in the Gastroenterology Department of the Zhongda Hospital of Southeast University from January 2020 to December 2024. General demographic information, lifestyle habits, family history of gastrointestinal tumors, blood routine, blood lipid tests, tumor markers, white light endoscopy, pathological diagnosis information, etc. were collected. Count data is described using mean or interquartile range, while categorical data is described using composition ratio. We analyze the relationship between various clinical indicators and both esophageal cancer and precancerous lesions using univariate and multivariate regression methods. Through inclusion and exclusion criteria, a total of 419 patients were included in this study. Its average age is 61.50 ± 9.51 years old, with a male proportion of 65.87%. The proportion of patients who smoke and drink alcohol is 16.46% and 14.56%, respectively. Among them, there were 204 patients in the normal group and 215 patients in the esophageal lesion group (precancerous lesions and esophageal cancer). Among them, the neutrophil to lymphocyte ratio (NLR), mononuclear lymphocyte ratio (MLR), and systemic inflammatory response index (SIRI) were significantly increased in the lesion group; The results of binary logistic regression analysis indicate that, MLR and Elevated Systemic Immune Inflammatory Index (SII) are independent risk factors for esophageal lesions. Subgroup analysis by gender also showed a significant correlation between elevated MLR and SII and esophageal lesions. Inflammatory markers in the blood are significantly correlated with esophageal cancer and precancerous lesions, and elevated MLR and SII are risk factors for esophageal cancer and precancerous lesions.