8%, 27.0%, and 11.6%, respectively (COP-NLR0 vs COP-NLR1, P < .001; COP-NLR1 vs COP-NLR2, P = .005; Figure 2). By univariate analysis, we found that seven clinicopathologic variables had significant associations with CSS (Table 3). Then, all of the seven significant variables above were included in a multivariate Cox proportional hazards model. In that model, we demonstrated that both the GPS (P = .003) and the COP-NLR (P = .003) were significant independent predictors of CSS ( Table 4). In addition, our study showed a similar hazard ratio (HR) between COP-NLR and GPS (HR = 1.394 vs HR = 1.367). There were significant positive correlations
between Alectinib in vivo COP-NLR and GPS (r = 0.494, P < .001). Our results showed significant negative correlations between CRP
and albumin (r = − 0.300, P < .001; Figure 3A), NLR and albumin (r = − 0.148, BGB324 price P = .004; Figure 3E), and platelet count and albumin (r = − 0.210, P < .001; Figure 3F). There were significant positive correlations between CRP and NLR (r = 0.157, P = .002; Figure 3B) and CRP and platelet count (r = 0.138, P = .007; Figure 3C). However, there were no correlation between NLR and platelet count (r = 0.079, P = .125; Figure 3D). AIC and BIC values were calculated by using logistic regression according to the survival status of patients when the follow-up was over. The AIC and BIC values were similar between COP-NLR and GPS, indicating that COP-NLR predicts survival in ESCC similar to GPS (Table 5). There is strong linkage between inflammation and cancer  and . In our study, we analyze the potential prognostic
values of COP-NLR and GPS in ESCC patients without adjuvant chemoradiotherapy mainly because chemotherapy or radiation will have an important impact on the systemic inflammation. To the best of our knowledge, this is the first study to show COP-NLR as an independent prognostic factor in patients with ESCC. Our study showed that both GPS (P = .003) and COP-NLR (P = .003) were significantly associated with CSS in multivariate analysis. We conclude that COP-NLR is an independent predictive factor in patients with ESCC, and it predicts survival similar to GPS. There are now a number of well-established systemic inflammation-based prognostic PRKD3 indexes for patients with EC. In particular, the GPS has been well validated. Several previous studies have shown that GPS is associated with survival in various cancers, including ECs ,  and . Our study showed that GPS was associated with tumor size, depth of invasion, and nodal metastasis. This observation is in line with data from Vashist et al.  but is contrary to the result of Kobayashi et al. , who suggested that GPS has no significant correlation with the above clinicopathologic factors. Moreover, our study demonstrated that COP-NLR is an independent predictive factor in patients with ESCC, and the result was consistent with previous studies  and .