Abstract: Objective To evaluate the prognostic value of neutrophil to lymphocyte ratio（NLR）in thoracic esophageal squamous cell carcinoma（TESCC）patients with lymph node metastasis.
Methods Clinical data of 313 TESCC patients treated with standard curative esophagectomy in the Affiliated Cancer Hospital of Zhengzhou University between April 2014 and April 2016 were collected.According to the median NLR value 3.2 of all patients，all patients were divided into high NLR group（≥3.2）and low NLR group（<3.2）.The general clinicopathological features of the two groups were compared，and the survival curves of  Overall survival（OS）and Disease-free survival（DFS）in the two groups were drawn and compared.Multivariate analysis was performed using Cox proportional risk model to determine prognostic factors.
Results 1-year and 3-year OS rates in high NLR group and low NLR group were 86.5%，56.2% and 88.9%，61.0%（P＞0.05），1-year and 3-year DFS rates in high NLR group and low NLR group were 71.1%，35.3% and 83.1%，47.1%（P＜0.05），respectively.Multivariate analysis showed that only pathological stage was an independent prognostic factor for OS（P＜ 0.05），while surgical approach，tumor differentiation degree，pathological stage and NLR（P＜0.05）were independent prognostic factors for DFS.
Conclusion NLR is valuable for predicting recurrence in TESCC patients with lymph node metastasis，but it can not be used as a predictive index for the overall survival time.

Key words: esophageal carcinoma, lymph node metastasis, neutrophil to lymphocyte ratio, prognosis