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Published in: World Journal of Surgical Oncology 1/2010

Open Access 01-12-2010 | Research

A pre-operative elevated neutrophil: lymphocyte ratio does not predict survival from oesophageal cancer resection

Authors: Farhan Rashid, Naseem Waraich, Imran Bhatti, Shopan Saha, Raheela N Khan, Javed Ahmed, Paul C Leeder, Mike Larvin, Syed Y Iftikhar

Published in: World Journal of Surgical Oncology | Issue 1/2010

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Abstract

Background

Elevated pre-operative neutrophil: lymphocyte ratio (NLR) has been identified as a predictor of survival in patients with hepatocellular and colorectal cancer. The aim of this study was to examine the prognostic value of an elevated preoperative NLR following resection for oesophageal cancer.

Methods

Patients who underwent resection for oesophageal carcinoma from June 1997 to September 2007 were identified from a local cancer database. Data on demographics, conventional prognostic markers, laboratory analyses including blood count results, and histopathology were collected and analysed.

Results

A total of 294 patients were identified with a median age at diagnosis of 65.2 (IQR 59-72) years. The median pre-operative time of blood sample collection was three days (IQR 1-8). The median neutrophil count was 64.2 × 10-9/litre, median lymphocyte count 23.9 × 10-9/litre, whilst the NLR was 2.69 (IQR 1.95-4.02). NLR did not prove to be a significant predictor of number of involved lymph nodes (Cox regression, p = 0.754), disease recurrence (p = 0.288) or death (Cox regression, p = 0.374). Furthermore, survival time was not significantly different between patients with high (≥ 3.5) or low (< 3.5) NLR (p = 0.49).

Conclusion

Preoperative NLR does not appear to offer useful predictive ability for outcome, disease-free and overall survival following oesophageal cancer resection.
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Literature
1.
go back to reference Tanaka S, Ueo H, Mafune K, Mori M, Wands JR, Sugimachi K: A novel isoform of human fibroblast growth factor 8 is induced by androgens and associated with progression of esophageal carcinoma. Dig Dis Sci. 2001, 46 (5): 1016-1021. 10.1023/A:1010753826788.CrossRefPubMed Tanaka S, Ueo H, Mafune K, Mori M, Wands JR, Sugimachi K: A novel isoform of human fibroblast growth factor 8 is induced by androgens and associated with progression of esophageal carcinoma. Dig Dis Sci. 2001, 46 (5): 1016-1021. 10.1023/A:1010753826788.CrossRefPubMed
2.
go back to reference Tanaka S, Hirabayashi Y: International Comparisons of Cumulative Risk of Oesophagus Cancer, from Cancer Incidence in Five Continents Vol. VIII. Jpn J Clin Oncol. 2006, 36 (9): 609-610. 10.1093/jjco/hyl103.CrossRefPubMed Tanaka S, Hirabayashi Y: International Comparisons of Cumulative Risk of Oesophagus Cancer, from Cancer Incidence in Five Continents Vol. VIII. Jpn J Clin Oncol. 2006, 36 (9): 609-610. 10.1093/jjco/hyl103.CrossRefPubMed
3.
go back to reference Pye JK, Crumplin MK, Charles J, Kerwat R, Foster ME, Biffin A: One-year survey of carcinoma of the oesophagus and stomach in Wales. Br J Surg. 2001, 88 (2): 278-285. 10.1046/j.1365-2168.2001.01655.x.CrossRefPubMed Pye JK, Crumplin MK, Charles J, Kerwat R, Foster ME, Biffin A: One-year survey of carcinoma of the oesophagus and stomach in Wales. Br J Surg. 2001, 88 (2): 278-285. 10.1046/j.1365-2168.2001.01655.x.CrossRefPubMed
4.
go back to reference Thomas P, Doddoli C, Lienne P, Morati N, Thirion X, Garbe L, Giudicelli R, Fuentes P: Changing patterns and surgical results in adenocarcinoma of the oesophagus. Br J Surg. 1997, 84 (1): 119-125. 10.1002/bjs.1800840143.CrossRefPubMed Thomas P, Doddoli C, Lienne P, Morati N, Thirion X, Garbe L, Giudicelli R, Fuentes P: Changing patterns and surgical results in adenocarcinoma of the oesophagus. Br J Surg. 1997, 84 (1): 119-125. 10.1002/bjs.1800840143.CrossRefPubMed
5.
go back to reference Omloo JM, Sloof GW, Boellaard R, Hoekstra OS, Jager PL, van Dullemen HM, Fockens P, Plukker JT, van Lanschot JJ: Importance of fluorodeoxyglucose-positron emission tomography (FDG-PET) and endoscopic ultrasonography parameters in predicting survival following surgery for esophageal cancer. Endoscopy. 2008, 40 (6): 464-471. 10.1055/s-2008-1077302.CrossRefPubMed Omloo JM, Sloof GW, Boellaard R, Hoekstra OS, Jager PL, van Dullemen HM, Fockens P, Plukker JT, van Lanschot JJ: Importance of fluorodeoxyglucose-positron emission tomography (FDG-PET) and endoscopic ultrasonography parameters in predicting survival following surgery for esophageal cancer. Endoscopy. 2008, 40 (6): 464-471. 10.1055/s-2008-1077302.CrossRefPubMed
6.
go back to reference Balkwill F, Mantovani A: Inflammation and cancer: back to Virchow?. Lancet. 2001, 357 (9255): 539-545. 10.1016/S0140-6736(00)04046-0.CrossRefPubMed Balkwill F, Mantovani A: Inflammation and cancer: back to Virchow?. Lancet. 2001, 357 (9255): 539-545. 10.1016/S0140-6736(00)04046-0.CrossRefPubMed
8.
go back to reference Gunter MJ, Stolzenberg-Solomon R, Cross AJ, Leitzmann MF, Weinstein S, Wood RJ, Virtamo J, Taylor PR, Albanes D, Sinha R: A prospective study of serum C-reactive protein and colorectal cancer risk in men. Cancer Res. 2006, 66 (4): 2483-2487. 10.1158/0008-5472.CAN-05-3631.CrossRefPubMed Gunter MJ, Stolzenberg-Solomon R, Cross AJ, Leitzmann MF, Weinstein S, Wood RJ, Virtamo J, Taylor PR, Albanes D, Sinha R: A prospective study of serum C-reactive protein and colorectal cancer risk in men. Cancer Res. 2006, 66 (4): 2483-2487. 10.1158/0008-5472.CAN-05-3631.CrossRefPubMed
9.
go back to reference Jackson JR, Seed MP, Kircher CH, Willoughby DA, Winkler JD: The codependence of angiogenesis and chronic inflammation. FASEB J. 1997, 11 (6): 457-465.PubMed Jackson JR, Seed MP, Kircher CH, Willoughby DA, Winkler JD: The codependence of angiogenesis and chronic inflammation. FASEB J. 1997, 11 (6): 457-465.PubMed
10.
go back to reference Jaiswal M, LaRusso NF, Burgart LJ, Gores GJ: Inflammatory cytokines induce DNA damage and inhibit DNA repair in cholangiocarcinoma cells by a nitric oxide-dependent mechanism. Cancer Res. 2000, 60 (1): 184-190.PubMed Jaiswal M, LaRusso NF, Burgart LJ, Gores GJ: Inflammatory cytokines induce DNA damage and inhibit DNA repair in cholangiocarcinoma cells by a nitric oxide-dependent mechanism. Cancer Res. 2000, 60 (1): 184-190.PubMed
11.
go back to reference Cho H, Hur HW, Kim SW, Kim SH, Kim JH, Kim YT, Lee K: Pre-treatment neutrophil to lymphocyte ratio is elevated in epithelial ovarian cancer and predicts survival after treatment. Cancer Immunol Immunother. 2008, 58 (1): 15-23. 10.1007/s00262-008-0516-3.CrossRefPubMed Cho H, Hur HW, Kim SW, Kim SH, Kim JH, Kim YT, Lee K: Pre-treatment neutrophil to lymphocyte ratio is elevated in epithelial ovarian cancer and predicts survival after treatment. Cancer Immunol Immunother. 2008, 58 (1): 15-23. 10.1007/s00262-008-0516-3.CrossRefPubMed
13.
go back to reference McMillan DC, Canna K, McArdle CS: Systemic inflammatory response predicts survival following curative resection of colorectal cancer. Br J Surg. 2003, 90 (2): 215-219. 10.1002/bjs.4038.CrossRefPubMed McMillan DC, Canna K, McArdle CS: Systemic inflammatory response predicts survival following curative resection of colorectal cancer. Br J Surg. 2003, 90 (2): 215-219. 10.1002/bjs.4038.CrossRefPubMed
14.
go back to reference McMillan DC, Wotherspoon HA, Fearon KC, Sturgeon C, Cooke TG, McArdle CS: A prospective study of tumor recurrence and the acute-phase response after apparently curative colorectal cancer surgery. Am J Surg. 1995, 170 (4): 319-322. 10.1016/S0002-9610(99)80296-7.CrossRefPubMed McMillan DC, Wotherspoon HA, Fearon KC, Sturgeon C, Cooke TG, McArdle CS: A prospective study of tumor recurrence and the acute-phase response after apparently curative colorectal cancer surgery. Am J Surg. 1995, 170 (4): 319-322. 10.1016/S0002-9610(99)80296-7.CrossRefPubMed
15.
go back to reference Halazun KJ, Aldoori A, Malik HZ, Al-Mukhtar A, Prasad KR, Toogood GJ, Lodge JP: Elevated preoperative neutrophil to lymphocyte ratio predicts survival following hepatic resection for colorectal liver metastases. Eur J Surg Oncol. 2008, 34 (1): 55-60.CrossRefPubMed Halazun KJ, Aldoori A, Malik HZ, Al-Mukhtar A, Prasad KR, Toogood GJ, Lodge JP: Elevated preoperative neutrophil to lymphocyte ratio predicts survival following hepatic resection for colorectal liver metastases. Eur J Surg Oncol. 2008, 34 (1): 55-60.CrossRefPubMed
16.
go back to reference Clark EJ, Connor S, Taylor MA, Madhavan KK, Garden OJ, Parks RW: Preoperative lymphocyte count as a prognostic factor in resected pancreatic ductal adenocarcinoma. HPB (Oxford). 2007, 9 (6): 456-460.CrossRef Clark EJ, Connor S, Taylor MA, Madhavan KK, Garden OJ, Parks RW: Preoperative lymphocyte count as a prognostic factor in resected pancreatic ductal adenocarcinoma. HPB (Oxford). 2007, 9 (6): 456-460.CrossRef
17.
go back to reference Duffy BK, Gurm HS, Rajagopal V, Gupta R, Ellis SG, Bhatt DL: Usefulness of an elevated neutrophil to lymphocyte ratio in predicting long-term mortality after percutaneous coronary intervention. Am J Cardiol. 2006, 97 (7): 993-996. 10.1016/j.amjcard.2005.10.034.CrossRefPubMed Duffy BK, Gurm HS, Rajagopal V, Gupta R, Ellis SG, Bhatt DL: Usefulness of an elevated neutrophil to lymphocyte ratio in predicting long-term mortality after percutaneous coronary intervention. Am J Cardiol. 2006, 97 (7): 993-996. 10.1016/j.amjcard.2005.10.034.CrossRefPubMed
18.
go back to reference Zahorec R: Ratio of neutrophil to lymphocyte counts--rapid and simple parameter of systemic inflammation and stress in critically ill. Bratisl Lek Listy. 2001, 102 (1): 5-14.PubMed Zahorec R: Ratio of neutrophil to lymphocyte counts--rapid and simple parameter of systemic inflammation and stress in critically ill. Bratisl Lek Listy. 2001, 102 (1): 5-14.PubMed
19.
go back to reference Walsh SR, Cook EJ, Goulder F, Justin TA, Keeling NJ: Neutrophil-lymphocyte ratio as a prognostic factor in colorectal cancer. J Surg Oncol. 2005, 91 (3): 181-184. 10.1002/jso.20329.CrossRefPubMed Walsh SR, Cook EJ, Goulder F, Justin TA, Keeling NJ: Neutrophil-lymphocyte ratio as a prognostic factor in colorectal cancer. J Surg Oncol. 2005, 91 (3): 181-184. 10.1002/jso.20329.CrossRefPubMed
20.
go back to reference Biarc J, Nguyen IS, Pini A, Gosse F, Richert S, Thierse D, Van Dorsselaer A, Leize-Wagner E, Raul F, Klein JP, Scholler-Guinard M: Carcinogenic properties of proteins with pro-inflammatory activity from Streptococcus infantarius (formerly S. bovis). Carcinogenesis. 2004, 25 (8): 1477-1484. 10.1093/carcin/bgh091.CrossRefPubMed Biarc J, Nguyen IS, Pini A, Gosse F, Richert S, Thierse D, Van Dorsselaer A, Leize-Wagner E, Raul F, Klein JP, Scholler-Guinard M: Carcinogenic properties of proteins with pro-inflammatory activity from Streptococcus infantarius (formerly S. bovis). Carcinogenesis. 2004, 25 (8): 1477-1484. 10.1093/carcin/bgh091.CrossRefPubMed
21.
go back to reference Brower V: Feeding the flame: new research adds to role of inflammation in cancer development. J Natl Cancer Inst. 2005, 97 (4): 251-253.CrossRefPubMed Brower V: Feeding the flame: new research adds to role of inflammation in cancer development. J Natl Cancer Inst. 2005, 97 (4): 251-253.CrossRefPubMed
22.
go back to reference Jaiswal M, LaRusso NF, Gores GJ: Nitric oxide in gastrointestinal epithelial cell carcinogenesis: linking inflammation to oncogenesis. Am J Physiol Gastrointest Liver Physiol. 2001, 281 (3): G626-634.PubMed Jaiswal M, LaRusso NF, Gores GJ: Nitric oxide in gastrointestinal epithelial cell carcinogenesis: linking inflammation to oncogenesis. Am J Physiol Gastrointest Liver Physiol. 2001, 281 (3): G626-634.PubMed
23.
go back to reference Bartsch H, Nair J: Oxidative stress and lipid peroxidation-derived DNA-lesions in inflammation driven carcinogenesis. Cancer Detect Prev. 2004, 28 (6): 385-391. 10.1016/j.cdp.2004.07.004.CrossRefPubMed Bartsch H, Nair J: Oxidative stress and lipid peroxidation-derived DNA-lesions in inflammation driven carcinogenesis. Cancer Detect Prev. 2004, 28 (6): 385-391. 10.1016/j.cdp.2004.07.004.CrossRefPubMed
24.
go back to reference Ropponen KM, Eskelinen MJ, Lipponen PK, Alhava E, Kosma VM: Prognostic value of tumour-infiltrating lymphocytes (TILs) in colorectal cancer. J Pathol. 1997, 182 (3): 318-324. 10.1002/(SICI)1096-9896(199707)182:3<318::AID-PATH862>3.0.CO;2-6.CrossRefPubMed Ropponen KM, Eskelinen MJ, Lipponen PK, Alhava E, Kosma VM: Prognostic value of tumour-infiltrating lymphocytes (TILs) in colorectal cancer. J Pathol. 1997, 182 (3): 318-324. 10.1002/(SICI)1096-9896(199707)182:3<318::AID-PATH862>3.0.CO;2-6.CrossRefPubMed
25.
go back to reference Dolcetti R, Viel A, Doglioni C, Russo A, Guidoboni M, Capozzi E, Vecchiato N, Macri E, Fornasarig M, Boiocchi M: High prevalence of activated intraepithelial cytotoxic T lymphocytes and increased neoplastic cell apoptosis in colorectal carcinomas with microsatellite instability. Am J Pathol. 1999, 154 (6): 1805-1813.PubMedCentralCrossRefPubMed Dolcetti R, Viel A, Doglioni C, Russo A, Guidoboni M, Capozzi E, Vecchiato N, Macri E, Fornasarig M, Boiocchi M: High prevalence of activated intraepithelial cytotoxic T lymphocytes and increased neoplastic cell apoptosis in colorectal carcinomas with microsatellite instability. Am J Pathol. 1999, 154 (6): 1805-1813.PubMedCentralCrossRefPubMed
26.
go back to reference Wenger FA, Jacobi CA, Zieren J, Docke W, Volk HD, Muller JM: Tumor size and lymph-node status in pancreatic carcinoma - is there a correlation to the preoperative immune function?. Langenbecks Arch Surg. 1999, 384 (5): 473-478. 10.1007/s004230050233.CrossRefPubMed Wenger FA, Jacobi CA, Zieren J, Docke W, Volk HD, Muller JM: Tumor size and lymph-node status in pancreatic carcinoma - is there a correlation to the preoperative immune function?. Langenbecks Arch Surg. 1999, 384 (5): 473-478. 10.1007/s004230050233.CrossRefPubMed
27.
go back to reference Menges T, Engel J, Welters I, Wagner RM, Little S, Ruwoldt R, Wollbrueck M, Hempelmann G: Changes in blood lymphocyte populations after multiple trauma: association with posttraumatic complications. Crit Care Med. 1999, 27 (4): 733-740. 10.1097/00003246-199904000-00026.CrossRefPubMed Menges T, Engel J, Welters I, Wagner RM, Little S, Ruwoldt R, Wollbrueck M, Hempelmann G: Changes in blood lymphocyte populations after multiple trauma: association with posttraumatic complications. Crit Care Med. 1999, 27 (4): 733-740. 10.1097/00003246-199904000-00026.CrossRefPubMed
28.
go back to reference Mukherjee M, Sahasrabuddhe MB: Effect of operation on peripheral lymphocyte counts and production of adenosine triphosphate (ATP) in cancer patients. J Surg Oncol. 1982, 20 (1): 1-8. 10.1002/jso.2930200102.CrossRefPubMed Mukherjee M, Sahasrabuddhe MB: Effect of operation on peripheral lymphocyte counts and production of adenosine triphosphate (ATP) in cancer patients. J Surg Oncol. 1982, 20 (1): 1-8. 10.1002/jso.2930200102.CrossRefPubMed
29.
go back to reference Hanahan D, Weinberg RA: The hallmarks of cancer. Cell. 2000, 100 (1): 57-70. 10.1016/S0092-8674(00)81683-9.CrossRefPubMed Hanahan D, Weinberg RA: The hallmarks of cancer. Cell. 2000, 100 (1): 57-70. 10.1016/S0092-8674(00)81683-9.CrossRefPubMed
30.
31.
go back to reference Lord BI, Bronchud MH, Owens S, Chang J, Howell A, Souza L, Dexter TM: The kinetics of human granulopoiesis following treatment with granulocyte colony-stimulating factor in vivo. Proc Natl Acad Sci USA. 1989, 86 (23): 9499-9503. 10.1073/pnas.86.23.9499.PubMedCentralCrossRefPubMed Lord BI, Bronchud MH, Owens S, Chang J, Howell A, Souza L, Dexter TM: The kinetics of human granulopoiesis following treatment with granulocyte colony-stimulating factor in vivo. Proc Natl Acad Sci USA. 1989, 86 (23): 9499-9503. 10.1073/pnas.86.23.9499.PubMedCentralCrossRefPubMed
32.
go back to reference Ulich TR, del Castillo J, Watson LR, Yin SM, Garnick MB: In vivo hematologic effects of recombinant human macrophage colony-stimulating factor. Blood. 1990, 75 (4): 846-850.PubMed Ulich TR, del Castillo J, Watson LR, Yin SM, Garnick MB: In vivo hematologic effects of recombinant human macrophage colony-stimulating factor. Blood. 1990, 75 (4): 846-850.PubMed
33.
go back to reference Aglietta M, Piacibello W, Sanavio F, Stacchini A, Apra F, Schena M, Mossetti C, Carnino F, Caligaris-Cappio F, Gavosto F: Kinetics of human hemopoietic cells after in vivo administration of granulocyte-macrophage colony-stimulating factor. J Clin Invest. 1989, 83 (2): 551-557. 10.1172/JCI113917.PubMedCentralCrossRefPubMed Aglietta M, Piacibello W, Sanavio F, Stacchini A, Apra F, Schena M, Mossetti C, Carnino F, Caligaris-Cappio F, Gavosto F: Kinetics of human hemopoietic cells after in vivo administration of granulocyte-macrophage colony-stimulating factor. J Clin Invest. 1989, 83 (2): 551-557. 10.1172/JCI113917.PubMedCentralCrossRefPubMed
34.
go back to reference Price TH, Chatta GS, Dale DC: Effect of recombinant granulocyte colony-stimulating factor on neutrophil kinetics in normal young and elderly humans. Blood. 1996, 88 (1): 335-340.PubMed Price TH, Chatta GS, Dale DC: Effect of recombinant granulocyte colony-stimulating factor on neutrophil kinetics in normal young and elderly humans. Blood. 1996, 88 (1): 335-340.PubMed
35.
go back to reference Uchida T, Yamagiwa A: Kinetics of rG-CSF-induced neutrophilia in mice. Exp Hematol. 1992, 20 (2): 152-155.PubMed Uchida T, Yamagiwa A: Kinetics of rG-CSF-induced neutrophilia in mice. Exp Hematol. 1992, 20 (2): 152-155.PubMed
36.
go back to reference Ulich TR, del Castillo J, Guo K, Souza L: The hematologic effects of chronic administration of the monokines tumor necrosis factor, interleukin-1, and granulocyte-colony stimulating factor on bone marrow and circulation. Am J Pathol. 1989, 134 (1): 149-159.PubMedCentralPubMed Ulich TR, del Castillo J, Guo K, Souza L: The hematologic effects of chronic administration of the monokines tumor necrosis factor, interleukin-1, and granulocyte-colony stimulating factor on bone marrow and circulation. Am J Pathol. 1989, 134 (1): 149-159.PubMedCentralPubMed
37.
go back to reference Ulich TR, del Castillo J, Guo KZ: In vivo hematologic effects of recombinant interleukin-6 on hematopoiesis and circulating numbers of RBCs and WBCs. Blood. 1989, 73 (1): 108-110.PubMed Ulich TR, del Castillo J, Guo KZ: In vivo hematologic effects of recombinant interleukin-6 on hematopoiesis and circulating numbers of RBCs and WBCs. Blood. 1989, 73 (1): 108-110.PubMed
38.
go back to reference Ulich TR, del Castillo J, Keys M, Granger GA, Ni RX: Kinetics and mechanisms of recombinant human interleukin 1 and tumor necrosis factor-alpha-induced changes in circulating numbers of neutrophils and lymphocytes. J Immunol. 1987, 139 (10): 3406-3415.PubMed Ulich TR, del Castillo J, Keys M, Granger GA, Ni RX: Kinetics and mechanisms of recombinant human interleukin 1 and tumor necrosis factor-alpha-induced changes in circulating numbers of neutrophils and lymphocytes. J Immunol. 1987, 139 (10): 3406-3415.PubMed
39.
go back to reference Romano F, Uggeri F, Crippa S, Di Stefano G, Scotti M, Scaini A, Caprotti R: Immunodeficiency in different histotypes of radically operable gastrointestinal cancers. J Exp Clin Cancer Res. 2004, 23 (2): 195-200.PubMed Romano F, Uggeri F, Crippa S, Di Stefano G, Scotti M, Scaini A, Caprotti R: Immunodeficiency in different histotypes of radically operable gastrointestinal cancers. J Exp Clin Cancer Res. 2004, 23 (2): 195-200.PubMed
40.
go back to reference Cho H, Hur HW, Kim SW, Kim SH, Kim JH, Kim YT, Lee K: Pre-treatment neutrophil to lymphocyte ratio is elevated in epithelial ovarian cancer and predicts survival after treatment. Cancer Immunol Immunother. 2009, 58 (1): 15-23. 10.1007/s00262-008-0516-3.CrossRefPubMed Cho H, Hur HW, Kim SW, Kim SH, Kim JH, Kim YT, Lee K: Pre-treatment neutrophil to lymphocyte ratio is elevated in epithelial ovarian cancer and predicts survival after treatment. Cancer Immunol Immunother. 2009, 58 (1): 15-23. 10.1007/s00262-008-0516-3.CrossRefPubMed
41.
go back to reference Gwak MS, Choi SJ, Kim JA, Ko JS, Kim TH, Lee SM, Park JA, Kim MH: Effects of gender on white blood cell populations and neutrophil-lymphocyte ratio following gastrectomy in patients with stomach cancer. J Korean Med Sci. 2007, 22 (Suppl): S104-108. 10.3346/jkms.2007.22.S.S104.PubMedCentralCrossRefPubMed Gwak MS, Choi SJ, Kim JA, Ko JS, Kim TH, Lee SM, Park JA, Kim MH: Effects of gender on white blood cell populations and neutrophil-lymphocyte ratio following gastrectomy in patients with stomach cancer. J Korean Med Sci. 2007, 22 (Suppl): S104-108. 10.3346/jkms.2007.22.S.S104.PubMedCentralCrossRefPubMed
42.
go back to reference Traustadottir T, Bosch PR, Matt KS: Gender differences in cardiovascular and hypothalamic-pituitary-adrenal axis responses to psychological stress in healthy older adult men and women. Stress. 2003, 6 (2): 133-140. 10.1080/1025389031000111302.CrossRefPubMed Traustadottir T, Bosch PR, Matt KS: Gender differences in cardiovascular and hypothalamic-pituitary-adrenal axis responses to psychological stress in healthy older adult men and women. Stress. 2003, 6 (2): 133-140. 10.1080/1025389031000111302.CrossRefPubMed
43.
go back to reference Deuster PA, Petrides JS, Singh A, Lucci EB, Chrousos GP, Gold PW: High intensity exercise promotes escape of adrenocorticotropin and cortisol from suppression by dexamethasone: sexually dimorphic responses. J Clin Endocrinol Metab. 1998, 83 (9): 3332-3338. 10.1210/jc.83.9.3332.PubMed Deuster PA, Petrides JS, Singh A, Lucci EB, Chrousos GP, Gold PW: High intensity exercise promotes escape of adrenocorticotropin and cortisol from suppression by dexamethasone: sexually dimorphic responses. J Clin Endocrinol Metab. 1998, 83 (9): 3332-3338. 10.1210/jc.83.9.3332.PubMed
44.
go back to reference Petrie EC, Wilkinson CW, Murray S, Jensen C, Peskind ER, Raskind MA: Effects of Alzheimer's disease and gender on the hypothalamic-pituitary-adrenal axis response to lumbar puncture stress. Psychoneuroendocrinology. 1999, 24 (4): 385-395. 10.1016/S0306-4530(98)00088-2.CrossRefPubMed Petrie EC, Wilkinson CW, Murray S, Jensen C, Peskind ER, Raskind MA: Effects of Alzheimer's disease and gender on the hypothalamic-pituitary-adrenal axis response to lumbar puncture stress. Psychoneuroendocrinology. 1999, 24 (4): 385-395. 10.1016/S0306-4530(98)00088-2.CrossRefPubMed
45.
go back to reference Finch CE, Crimmins EM: Inflammatory exposure and historical changes in human life-spans. Science. 2004, 305 (5691): 1736-1739. 10.1126/science.1092556.CrossRefPubMed Finch CE, Crimmins EM: Inflammatory exposure and historical changes in human life-spans. Science. 2004, 305 (5691): 1736-1739. 10.1126/science.1092556.CrossRefPubMed
46.
go back to reference Krabbe KS, Pedersen M, Bruunsgaard H: Inflammatory mediators in the elderly. Exp Gerontol. 2004, 39 (5): 687-699. 10.1016/j.exger.2004.01.009.CrossRefPubMed Krabbe KS, Pedersen M, Bruunsgaard H: Inflammatory mediators in the elderly. Exp Gerontol. 2004, 39 (5): 687-699. 10.1016/j.exger.2004.01.009.CrossRefPubMed
Metadata
Title
A pre-operative elevated neutrophil: lymphocyte ratio does not predict survival from oesophageal cancer resection
Authors
Farhan Rashid
Naseem Waraich
Imran Bhatti
Shopan Saha
Raheela N Khan
Javed Ahmed
Paul C Leeder
Mike Larvin
Syed Y Iftikhar
Publication date
01-12-2010
Publisher
BioMed Central
Published in
World Journal of Surgical Oncology / Issue 1/2010
Electronic ISSN: 1477-7819
DOI
https://doi.org/10.1186/1477-7819-8-1

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