To evaluate the value of neutrophil-to-lymphocyte ratio (NLR) and fibrinogen (FIB) in the diagnosis of esophageal cancer (EC), and analyze the relationship of NLR and FIB with clinicopathological stages of EC.

A total of 224 patients with EC, 79 patients with precancerous EC lesions, and 218 patients with gastroesophageal reflux disease (GERD) were enrolled at Huai'an Hospital Affiliated to Xuzhou Medical University from June 2017 to June 2020, and 214 healthy controls were also included. The levels of NLR, FIB, and carcinoembryonic antigen (CEA) in the four groups were compared, and the areas under the receiver operating characteristic curves (AUCs) of NLR, FIB, and CEA in the diagnosis of EC were calculated, and the best cutoff value, sensitivity, and specificity were obtained. Finally, the relationship of the levels of NLR, FIB, and CEA with TNM stage in EC patients was analyzed.

NLR and FIB in the EC group were significantly higher than those in the other three groups (P＜0.05). CEA in the EC group was significantly higher than those in the GERD group and control group (P＜0.05), but there was no significant difference in CEA between the EC group and precancerous lesion group (P＞0.05). NLR, FIB, and CEA in the EC precancerous lesion group were significantly higher than those of the control group (P＜0.05), but there was no statistical difference between EC precancerous lesion group and GERD group (P＞0.05). Among the NLR, FIB, and CEA, only NLR showed a statistically significant difference between the GERD group and control group (P＜0.05). The AUCs of NLR, FIB, and CEA in the diagnosis of EC were 0.76, 0.73, and 0.61; the best cutoff values were 2.48, 2.75 g/L, and 2.06 ng/ml; the sensitivities were 72.8%, 65.3%, and 62.0%; and the specificities were 64.3%, 69.0%, and 59.2%, respectively. The diagnostic efficacy of NLR and FIB was better than that of CEA (P＜0.05), but there was no significant difference between NLR and FIB (P＞0.05). The levels of NLR and FIB were significantly different among different TNM stages of EC (P＜0.05). Correlation analysis showed that NLR, FIB, and CEA were positively correlated with EC stage (r=0.25, 0.19, and 0.19, respectively, P＜0.05).

NLR and FIB in peripheral blood significantly increase in patients with EC. The diagnostic efficacy of NLR and FIB in EC is better than that of CEA, and the levels of NLR and FIB correlate with the clinicopathological stage of EC.