Neutrophil-Lymphocyte Ratio May be Used as a Biomarker for Predicting Progression of Barrett's Esophagus to Esophageal Adenocarcinoma: A Retrospective Cohort Study.

Aims: This study aims to investigate the correlation between the neutrophil-lymphocyte ratio (NLR) and advancing stages of Barrett's esophagus (BE) to esophageal adenocarcinoma (EAC).

Methods And Results: A retrospective cohort of patients diagnosed with BE and EAC were analyzed. Cases were categorized into four groups according to their histological diagnosis: non-dysplastic BE (NDBE), low-grade dysplasia (LGD), high-grade dysplasia (HGD), and EAC. The NLR was calculated from a complete blood cell count within 6 months prior to diagnosis. A total of 140 patients were analyzed with a mean age of 67. The majority of patients were male (78.6%) and Caucasian (96.4%). Of the total, 32 (22.9%) patients had NDBE, 20 (14.3%) had LGD, 20 (14.3%) had HGD, and 68 (48.6%) had EAC. There was a statistically significant difference in NLR scores across the histological diagnoses. The mean NLR rank scores were 48.22 for NDBE, 44.75 for LGD, 60.35 for HGD, and 91.54 for EAC. Post hoc tests confirmed significant differences in NLR between NDBE and EAC, as well as LGD and EAC.

Conclusions: The study supports the potential use of NLR as a biomarker for predicting histologic progression in BE to EAC. The NLR could serve as a useful adjunct to current surveillance strategies to help guide clinical decision-making. Further research is necessary to validate these findings and determine the clinical utility of NLR as a predictor for dysplasia and neoplasia in BE patients.