Prognostic value of preoperative lymphocyte-to-monocyte ratio in oral cancer patients and establishment of a dynamic nomogram
Prognostic value of preoperative lymphocyte-to-monocyte ratio in oral cancer patients and establishment of a dynamic nomogram
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DOI：
10.1111/odi.13629
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发表时间：
2021-02-23
期刊：
影响因子：
3.8
通讯作者：
Chen, Fa
中科院分区：
文献类型：
--
作者：
Chen, Lin;Qian, Jiawen;Chen, Fa
目的探讨术前淋巴细胞/单核细胞比值（LMR）与口腔癌患者总生存期（OS）的关系，并建立一个动态诺模图，用于个体化生存期预测。方法对2010年1月至2017年12月间651例口腔癌术后患者进行大规模队列研究，评估LMR的预后价值。进行倾向评分匹配（PSM）分析和治疗加权逆概率（IPTW）分析以进一步验证LMR的预后价值。结果LMR越高，口腔癌患者的OS越好（HR = 0.65，95%CI = 0.44-0.98）。在PSM和IPTW分析中也观察到类似的关联。此外，与TNM分期系统相比，基于LMR的动态诺模图表现出更好的预测性能（0.72 vs 0.64，p <0.001），校准曲线（1,000个自助重新采样）表明实际和预测概率之间的良好匹配。决策曲线分析（DCAs）显示了更显着的积极净效益在实际范围内的阈值probabilities使用的动态nomogl.Conclusion术前LMR可能作为一个容易获得的和非侵入性的预后生物标志物，用于预测口腔癌患者的预后。基于LMR的动态诺模图可更方便地用于口腔癌患者的生存预测。未来的进一步研究是必要的，以证实我们的发现。
Objective To assess the association of preoperative lymphocyte-to-monocyte ratio (LMR) and overall survival (OS) in patients with oral cancer and develop a dynamic nomogram for individualized survival prediction.Method The prognostic value of LMR was evaluated in a large-scale cohort with 651 postoperative patients with oral cancer between January 2010 and December 2017. Propensity score-matched (PSM) analysis and inverse probability of treatment weighting (IPTW) analysis were performed to further verify the prognostic value of LMR. A dynamic nomogram was then developed based on the LMR and clinicopathological features, and its predictive performance and clinical utility were evaluated.Results A high LMR was significantly associated with better OS of patients with oral cancer (HR = 0.65; 95% CI = 0.44-0.98). The similar association was also observed in the PSM and IPTW analyses. Moreover, compared with TNM staging system, the dynamic nomogram based on the LMR exhibited more excellent predictive performance (0.72 versus 0.64, p < .001), with calibration curves (1,000 bootstrap resamples) suggesting good match between the actual and predicted probabilities. Decision curve analyses (DCAs) showed a more significant positive net benefit in the practical ranges of threshold probabilities using the dynamic nomogram.Conclusion Preoperative LMR may serve as an easily accessible and non-invasive prognostic biomarker for predicting the prognosis of patients with oral cancer. A dynamic nomogram based on the LMR may show more convenience in survival prediction for patients with oral cancer. Further future studies are warranted to confirm our findings.