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Predictive value of pretreatment peripheral blood N/CD4 and N/CD8 ratios for the efficacy of radiotherapy for esophageal cancer

Yu-Rong Jiang

Yu-Rong Jiang

Department of Thoracic Oncology, Cancer Institute of Jiangsu University, Affiliated Hospital of Jiangsu UniversityZhenjiang, P. R. China
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Jiang, Yu-Rong
, 
Yu-Ting Su

Yu-Ting Su

Department of Abdominal Oncology, Cancer Institute of Jiangsu University, Affiliated Hospital of Jiangsu UniversityZhenjiang, P. R. China
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Su, Yu-Ting
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Jing Hu

Jing Hu

Department of Thoracic Oncology, Cancer Institute of Jiangsu University, Affiliated Hospital of Jiangsu UniversityZhenjiang, P. R. China
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Hu, Jing
, 
Yan Ding

Yan Ding

Department of Head and Neck and Comprehensive Oncology, Cancer Institute of Jiangsu University, Affiliated Hospital of Jiangsu UniversityZhenjiang, P. R. China
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Ding, Yan
, 
Lu Wang

Lu Wang

Department of Abdominal Oncology, Cancer Institute of Jiangsu University, Affiliated Hospital of Jiangsu UniversityZhenjiang, P. R. China
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Wang, Lu
, 
Zi-Yu Wang

Zi-Yu Wang

Department of Thoracic Oncology, Cancer Institute of Jiangsu University, Affiliated Hospital of Jiangsu UniversityZhenjiang, P. R. China
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Wang, Zi-Yu
, 
Wan-Ying Sheng

Wan-Ying Sheng

Department of Thoracic Oncology, Cancer Institute of Jiangsu University, Affiliated Hospital of Jiangsu UniversityZhenjiang, P. R. China
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Sheng, Wan-Ying
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Yi-Xu Fan

Yi-Xu Fan

Department of Thoracic Oncology, Cancer Institute of Jiangsu University, Affiliated Hospital of Jiangsu UniversityZhenjiang, P. R. China
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Fan, Yi-Xu
, 
Liang-Mei Chu

Liang-Mei Chu

Department of Thoracic Oncology, Cancer Institute of Jiangsu University, Affiliated Hospital of Jiangsu UniversityZhenjiang, P. R. China
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Chu, Liang-Mei
, 
Yu-Fei Yang

Yu-Fei Yang

Department of Head and Neck and Comprehensive Oncology, Cancer Institute of Jiangsu University, Affiliated Hospital of Jiangsu UniversityZhenjiang, P. R. China
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Yang, Yu-Fei
, 
Yi Wen

Yi Wen

Department of Thoracic Oncology, Cancer Institute of Jiangsu University, Affiliated Hospital of Jiangsu UniversityZhenjiang, P. R. China
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Wen, Yi
, 
Miao Han

Miao Han

Department of Head and Neck and Comprehensive Oncology, Cancer Institute of Jiangsu University, Affiliated Hospital of Jiangsu UniversityZhenjiang, P. R. China
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Han, Miao
, 
Si-Yuan Zhou

Si-Yuan Zhou

Department of Thoracic Oncology, Cancer Institute of Jiangsu University, Affiliated Hospital of Jiangsu UniversityZhenjiang, P. R. China
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Zhou, Si-Yuan
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Chun-Hua Dai

Chun-Hua Dai

Department of Thoracic Oncology, Cancer Institute of Jiangsu University, Affiliated Hospital of Jiangsu UniversityZhenjiang, P. R. China
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Dai, Chun-Hua
 und 
Xu Wang

Xu Wang

Department of Thoracic Oncology, Cancer Institute of Jiangsu University, Affiliated Hospital of Jiangsu UniversityZhenjiang, P. R. China
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Wang, Xu
  
19. März 2025
Predictive value of pretreatment peripheral blood N/CD4 and N/CD8 ratios for the efficacy of radiotherapy for esophageal cancer's Cover Image
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Artikel-Kategorie: research article
Online veröffentlicht: 19. März 2025
Seitenbereich: 257 - 266
Eingereicht: 28. Aug. 2024
Akzeptiert: 06. Dez. 2024
DOI: https://doi.org/10.2478/raon-2025-0015
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© 2025 Yu-Rong Jiang et al., published by Sciendo
This work is licensed under the Creative Commons Attribution 4.0 International License.

Figure 1.

Receiver operating characteristics (ROC) curve plotted to determine the value of a statistically significant variable in the Cox regression model for neutrophil-to-CD4+ T-cell ratio (N/CD4) (A) and neutrophil-to-CD8+ T-cell ratio (N/CD8) (B) according to ROC analysis, the area under the curve of N/CD4 and N/CD8 was 0.763 and 0.763, respectively, and the optimal cutoff point was 0.01053329 and 0.01184294, respectively.
Receiver operating characteristics (ROC) curve plotted to determine the value of a statistically significant variable in the Cox regression model for neutrophil-to-CD4+ T-cell ratio (N/CD4) (A) and neutrophil-to-CD8+ T-cell ratio (N/CD8) (B) according to ROC analysis, the area under the curve of N/CD4 and N/CD8 was 0.763 and 0.763, respectively, and the optimal cutoff point was 0.01053329 and 0.01184294, respectively.

Figure 2A

Kaplan-Meier survival curves for patients with advanced oesophageal cancer in different neutrophil-to-CD4+ T-cell ratio (N/CD4) groups. The red curve represents the overall survival of patients with an N/CD4 less than 0.01053329, while the blue curve represents the overall survival of patients with an N/CD4 greater than or equal to 0.01053329. The mean survival time of patients in the low- and hight-N/CD4 group were 372 and 750 days, respectively, with a p < 0.05, indicating a significant difference between the two groups.
Kaplan-Meier survival curves for patients with advanced oesophageal cancer in different neutrophil-to-CD4+ T-cell ratio (N/CD4) groups. The red curve represents the overall survival of patients with an N/CD4 less than 0.01053329, while the blue curve represents the overall survival of patients with an N/CD4 greater than or equal to 0.01053329. The mean survival time of patients in the low- and hight-N/CD4 group were 372 and 750 days, respectively, with a p < 0.05, indicating a significant difference between the two groups.

Figure 2B

Kaplan-Meier survival curves for patients with advanced cancer in different neutrophil-to-CD4+ T-cell ratio (N/CD4) groups. The red curve represents the overall survival of patients with an N/CD4 less than 0.01184294, while the blue curve represents the overall survival of patients with an N/CD4 greater than or equal to 0.01184294. The mean survival time of patients in the low- and high-N/CD4 group were 751 and 310 days, respectively, with a p < 0.05, indicating a significant difference between the two groups.
Kaplan-Meier survival curves for patients with advanced cancer in different neutrophil-to-CD4+ T-cell ratio (N/CD4) groups. The red curve represents the overall survival of patients with an N/CD4 less than 0.01184294, while the blue curve represents the overall survival of patients with an N/CD4 greater than or equal to 0.01184294. The mean survival time of patients in the low- and high-N/CD4 group were 751 and 310 days, respectively, with a p < 0.05, indicating a significant difference between the two groups.

Univariate Cox regression analysis of the relationship between pathophysiological parameters and survival time of patients

Parameter 95% CI P-value
Sex 0.5551–0.7782 0.863
Age 0.7621–0.9324 0.424
Smoking history 0.1238–0.3206 0.150
Drinking history 0.1356–0.3366 0.073
Differentiation 1.8861–2.1416 0.876
Tumor site 1.9172–2.2495 0.977
Histology 0.9993–1.1951 0.150
T-staging 1.4667–1.7000 0.484
N-staging 0.4812–0.7133 0.644
ECOG score 0.3196–0.6248 0.000
Lymphocytes 1.1019–1.3953 0.690
Neutrophils 4.5463–6.0399 0.101
CD4 494.9039–630.8183 0.003
CD8 318.8047–410.5008 0.099
B 127.2621–174.9045 0.441
NK 311.61–429.0567 0.345
CD4/CD8 1.5587–1.9595 0.380
NLR 4.11727–5.9177 0.219
N/CD4 0.00989131–0.01451622 0.000
N/CD8 0.01492113–0.02114241 0.000
N/B 0.04171439–0.07256377 0.020
N/NK 0.01579055–0.02567177 0.141

Association of pathological features and neutrophil-to-CD4+ T-cell ratio (N/CD4) in patients

Characteristic, n = 72 N/CD4 ≤ 0.01053329 N/CD4 > 0.01053329 P-value
Sex
   Female 12 12
   Male 28 20 0.502
Age
   ≥ 64 years old 33 28
   < 64 years old 7 4 0.558
History of smoking
   Yes 8 8
   No 24 32 0.612
Drinking history
   Yes 10 7
   No 30 25 0.756
Differentiation
   Highly differentiation 6 5
   Medium differentiation 29 22
   Low differentiation 5 5 0.228
Tumor site
   Upper thoracic portion 9 6
   Middle thoracic portion 23 13
   Low thoracic portion 8 13 0.032
Histology
   Squamous 36 32
   Nonsquamous 1 0
   Small cell 3 0 0.368
T-staging
   T1 + T2 15 15
   T3 + T4 25 17 0.423
N-staging
   N0 19 10
   N1 + N2 21 22 0.162
Nutriture
   Benign 19 13
   Unbenign 21 19 0.56
Anemic state
   Not anemic 7 15
   Anemia 33 17 0.007
Coagulation state
   Normal 30 23
   Abnormal 10 9 0.765
ECOG score
   0 point 24 20
   1 point 11 11
   2 point 5 1 0.366
Treatment efficacy
   CR + PR 26 21
   SD + PD 14 11 0.956

Multivariate Cox regression analysis of the relationship between clinical variables and patient survival

Parameter HR 95% CI Lower 95% CI Upper P-value
N/CD4 4.14E+73 3.39128E+18 5.07E+128 0.009
ECOG 2.151826047 1.202835884 3.849532092 0.010
N/CD8 4.27E-41 2.01E-75 9.04E-07 0.021
N/B 0.00138624 6.32E-12 303904.1296 0.502
CD4 0.999658052 0.997587163 1.00173324 0.747

Association of pathological features and neutrophil-to-CD8+ T-cell ratio (N/CD8) in patients

Characteristic, n = 72 N/CD8 ≤ 0.01184294 N/CD8 > 0.01184294 P-value
Sex
   Female 9 15
   Male 20 28 0.734
Age
   ≥ 64 years old 26 35
   < 64 years old 3 8 0.339
History of smoking
   Yes 6 10
   No 23 33 0.797
Drinking history
   Yes 6 11
   No 23 32 0.632
Differentiation
   Highly differentiation 5 6
   Medium differentiation 19 32
   Low differentiation 5 5 0.040
Tumor site
   Upper thoracic portion 4 11
   Middle thoracic portion 15 21
   Low thoracic portion 10 11 0.047
Histology
   Squamous 27 41
   Nonsquamous 1 0
   Small cell 1 2 0.802
T-staging
   T1 + T2 12 18
   T3 + T4 17 25 0.968
N-staging
   N0 13 16
   N1 + N2 16 27 0.518
Nutriture
   Benign 15 17
   Unbenign 14 26 0.307
Anemic state
   Not anemic 7 15
   Anemia 22 28 0.332
Coagulation state
   Normal 20 33
   Abnormal 9 10 0.463
ECOG score
   0 point 22 22
   1 point 7 15
   2 point 0 6 0.035
Treatment efficacy
   CR + PR 26 21
   SD + PD 3 22 0.000

Basic physiological and physiological characteristics of 72 patients

Characteristic No of patents (%)
All patients (%) 72 (100%)
Sex
   Female 24 (33.3%)
   Male 48 (66.7%)
Age
   Mean-SD 64 years
   Range 52-98
   64-year old or older 61 (84.7%)
   Under 64-year old 11 (15.3%)
History of smoking
   Yes 16 (22.2%)
   No 56 (77.8%)
Drinking history
Yes 17 (23.6%)
No 55 (76.4%)
Differentiation
   Highly differentiation    11 (15.3%)
   Medium differentiation 51 (70.8%)
   Low differentiation 10 (13.9%)
Tumor site
   Upper thoracic portion 15 (20.8%)
   Middle thoracic portion 36 (50.0%)
   Low thoracic portion 21 (29.2%)
Histology
   Squamous 68 (94.4%)
   Non-squamous 1 (1.4%)
   Small cell 3 (4.2%)
T-staging
   T1 + T2 30 (41.7%)
   T3 + T4 42 (58.3%)
N-staging
   N0 29 (40.3%)
   N1 + N2 43 (59,7%)
Nutriture
   Benign 32 (44.4%)
   Unbenign 40 (55.6%)
Anemic state
   Not anemic 51 (70.8%)
   Anemia 21 (29.2%)
Coagulation state
   Normal 63 (87.5%)
   Abnormal 9 (12.5%)
ECOG score
   0 point 44 (61.1%)
   1 point 22 (30.6%)
   2 point 6 (8.3%)
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