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

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

Radiology and Oncology
Volume 59 (2025): Issue 2 (June 2025)
By: Yu-Rong Jiang,  Yu-Ting Su,  Jing Hu,  Yan Ding,  Lu Wang,  Zi-Yu Wang,  Wan-Ying Sheng,  Yi-Xu Fan,  Liang-Mei Chu,  Yu-Fei Yang,  Yi Wen,  Miao Han,  Si-Yuan Zhou,  Chun-Hua Dai and  Xu Wang  
Open Access
|Mar 2025

Figures & Tables

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

Parameter95% CIP-value
Sex0.5551–0.77820.863
Age0.7621–0.93240.424
Smoking history0.1238–0.32060.150
Drinking history0.1356–0.33660.073
Differentiation1.8861–2.14160.876
Tumor site1.9172–2.24950.977
Histology0.9993–1.19510.150
T-staging1.4667–1.70000.484
N-staging0.4812–0.71330.644
ECOG score0.3196–0.62480.000
Lymphocytes1.1019–1.39530.690
Neutrophils4.5463–6.03990.101
CD4494.9039–630.81830.003
CD8318.8047–410.50080.099
B127.2621–174.90450.441
NK311.61–429.05670.345
CD4/CD81.5587–1.95950.380
NLR4.11727–5.91770.219
N/CD40.00989131–0.014516220.000
N/CD80.01492113–0.021142410.000
N/B0.04171439–0.072563770.020
N/NK0.01579055–0.025671770.141

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

Characteristic, n = 72N/CD4 ≤ 0.01053329N/CD4 > 0.01053329P-value
Sex
   Female1212
   Male28200.502
Age
   ≥ 64 years old3328
   < 64 years old740.558
History of smoking
   Yes88
   No24320.612
Drinking history
   Yes107
   No30250.756
Differentiation
   Highly differentiation65
   Medium differentiation2922
   Low differentiation550.228
Tumor site
   Upper thoracic portion96
   Middle thoracic portion2313
   Low thoracic portion8130.032
Histology
   Squamous3632
   Nonsquamous10
   Small cell300.368
T-staging
   T1 + T21515
   T3 + T425170.423
N-staging
   N01910
   N1 + N221220.162
Nutriture
   Benign1913
   Unbenign21190.56
Anemic state
   Not anemic715
   Anemia33170.007
Coagulation state
   Normal3023
   Abnormal1090.765
ECOG score
   0 point2420
   1 point1111
   2 point510.366
Treatment efficacy
   CR + PR2621
   SD + PD14110.956

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

ParameterHR95% CI Lower95% CI UpperP-value
N/CD44.14E+733.39128E+185.07E+1280.009
ECOG2.1518260471.2028358843.8495320920.010
N/CD84.27E-412.01E-759.04E-070.021
N/B0.001386246.32E-12303904.12960.502
CD40.9996580520.9975871631.001733240.747

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

Characteristic, n = 72N/CD8 ≤ 0.01184294N/CD8 > 0.01184294P-value
Sex
   Female915
   Male20280.734
Age
   ≥ 64 years old2635
   < 64 years old380.339
History of smoking
   Yes610
   No23330.797
Drinking history
   Yes611
   No23320.632
Differentiation
   Highly differentiation56
   Medium differentiation1932
   Low differentiation550.040
Tumor site
   Upper thoracic portion411
   Middle thoracic portion1521
   Low thoracic portion10110.047
Histology
   Squamous2741
   Nonsquamous10
   Small cell120.802
T-staging
   T1 + T21218
   T3 + T417250.968
N-staging
   N01316
   N1 + N216270.518
Nutriture
   Benign1517
   Unbenign14260.307
Anemic state
   Not anemic715
   Anemia22280.332
Coagulation state
   Normal2033
   Abnormal9100.463
ECOG score
   0 point2222
   1 point715
   2 point060.035
Treatment efficacy
   CR + PR2621
   SD + PD3220.000

Basic physiological and physiological characteristics of 72 patients

CharacteristicNo of patents (%)
All patients (%)72 (100%)
Sex
   Female24 (33.3%)
   Male48 (66.7%)
Age
   Mean-SD64 years
   Range52-98
   64-year old or older61 (84.7%)
   Under 64-year old11 (15.3%)
History of smoking
   Yes16 (22.2%)
   No56 (77.8%)
Drinking history
Yes17 (23.6%)
No55 (76.4%)
Differentiation
   Highly differentiation   11 (15.3%)
   Medium differentiation51 (70.8%)
   Low differentiation10 (13.9%)
Tumor site
   Upper thoracic portion15 (20.8%)
   Middle thoracic portion36 (50.0%)
   Low thoracic portion21 (29.2%)
Histology
   Squamous68 (94.4%)
   Non-squamous1 (1.4%)
   Small cell3 (4.2%)
T-staging
   T1 + T230 (41.7%)
   T3 + T442 (58.3%)
N-staging
   N029 (40.3%)
   N1 + N243 (59,7%)
Nutriture
   Benign32 (44.4%)
   Unbenign40 (55.6%)
Anemic state
   Not anemic51 (70.8%)
   Anemia21 (29.2%)
Coagulation state
   Normal63 (87.5%)
   Abnormal9 (12.5%)
ECOG score
   0 point44 (61.1%)
   1 point22 (30.6%)
   2 point6 (8.3%)
DOI: https://doi.org/10.2478/raon-2025-0015 | Journal eISSN: 1581-3207 | Journal ISSN: 1318-2099
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Language: English
Page range: 257 - 266
Submitted on: Aug 28, 2024
Accepted on: Dec 6, 2024
Published on: Mar 19, 2025
Published by: Association of Radiology and Oncology
In partnership with: Paradigm Publishing Services
Publication frequency: 4 issues per year
Keywords:
peripheral blood N/CD4 and N/CD8,
esophageal cancer,
radiotherapy,
efficacy prediction
Related subjects:
Medicine,
Clinical medicine,
Internal medicine,
Haematology, oncology,
Radiology

© 2025 Yu-Rong Jiang, Yu-Ting Su, Jing Hu, Yan Ding, Lu Wang, Zi-Yu Wang, Wan-Ying Sheng, Yi-Xu Fan, Liang-Mei Chu, Yu-Fei Yang, Yi Wen, Miao Han, Si-Yuan Zhou, Chun-Hua Dai, Xu Wang, published by Association of Radiology and Oncology
This work is licensed under the Creative Commons Attribution 4.0 License.

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