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Journal of Gastrointestinal Surgery
Published in: Journal of Gastrointestinal Surgery 1/2020

01-01-2020 | Endoscopy | 2019 SSAT Plenary Presentation

Neutrophil-Lymphocyte Ratio as a Marker of Progression from Non-Dysplastic Barrett’s Esophagus to Esophageal Adenocarcinoma: a Cross-Sectional Retrospective Study

Authors: Vinicius J. Campos, Guilherme S. Mazzini, José F. Juchem, Richard R. Gurski

Published in: Journal of Gastrointestinal Surgery | Issue 1/2020

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Abstract

Background

Immune imbalance and inflammation have been suggested as key factors of Barrett’s esophagus (BE) pathway towards adenocarcinoma. The neutrophil-lymphocyte ratio (NLR) indirectly reflects the relation between innate and adaptive immune systems and has been studied in premalignant conditions as a biomarker for cancer diagnosis. Our aim was to investigate if increasing values of NLR correlated with advancing stages of BE progression to dysplasia and neoplasia.

Methods

We retrospectively analyzed data of patients with biopsies reporting BE between 2013 and 2017 and with a complete blood count within 6 months from the endoscopy, as well as patients with esophageal adenocarcinoma (EAC). NLR was calculated as neutrophil count/lymphocyte count. Cases (n = 113) were classified as non-dysplastic BE (NDBE, n = 72), dysplastic BE (DBE, n = 11) and EAC (n = 30).

Results

NLR progressively increased across groups (NDBE, 1.92 ± 0.7; DBE, 2.92 ± 1.1; EAC 4.54 ± 2.9), with a significant correlation between its increasing value and the presence of dysplasia or neoplasia (r = 0.53, p < 0.001). NLR > 2.27 was able to diagnose EAC with 80% sensitivity and 71% specificity (area under the curve = 0.8).

Conclusion

NLR correlates with advancing stages of BE progression, a finding that reinforces the role of immune imbalance in EAC carcinogenesis and suggests a possible use of this marker for risk stratification on surveillance strategies.
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Metadata
Title
Neutrophil-Lymphocyte Ratio as a Marker of Progression from Non-Dysplastic Barrett’s Esophagus to Esophageal Adenocarcinoma: a Cross-Sectional Retrospective Study
Authors
Vinicius J. Campos
Guilherme S. Mazzini
José F. Juchem
Richard R. Gurski
Publication date
01-01-2020
Publisher
Springer US
Published in
Journal of Gastrointestinal Surgery / Issue 1/2020
Print ISSN: 1091-255X
Electronic ISSN: 1873-4626
DOI
https://doi.org/10.1007/s11605-019-04456-x

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