Clinical Implications of Pretreatment: Lymphocyte-to-Monocyte Ratio in Patients With Rectal Cancer Receiving Preoperative Chemoradiotherapy.
Clinical Implications of Pretreatment: Lymphocyte-to-Monocyte Ratio in Patients With Rectal Cancer Receiving Preoperative Chemoradiotherapy.
复制标题
预处理的临床意义：接受术前放化疗的直肠癌患者的淋巴细胞与单核细胞比率。
DOI：
10.1097/dcr.0000000000001245
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发表时间：
2019
期刊：
影响因子：
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通讯作者：
Kusunoki M.
中科院分区：
文献类型：
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作者：
Yamamoto A;Toiyama Y;Okugawa Y;Oki S;Ide S;Saigusa S;Araki T;Kusunoki M.
背景：尽管直肠癌的局部控制取得了进展，但远处器官的复发仍然是死亡的主要原因之一。预后生物标志物对于直肠癌患者的治疗具有重要意义。 目的：本研究旨在探讨淋巴细胞与单核细胞比值对接受术前放化疗的直肠癌患者预后的影响，并阐明淋巴细胞与单核细胞比值的临床意义。设计：回顾性评估直肠癌患者的前瞻性数据，以阐明淋巴细胞与单核细胞比值的临床相关性。地点：本研究是在单一专家中心进行的。患者：共有 119 名在我们研究所连续接受放化疗和全直肠系膜切除的直肠癌患者纳入本研究。由于缺乏实验室数据，本研究中排除了 8 例患者，最终评估了 111 例患者。 主要观察指标：主要观察指标为接受放化疗的直肠癌患者淋巴细胞与单核细胞比率的临床相关性。 结果：治疗前淋巴细胞与单核细胞比率较低的患者在接受放化疗的直肠癌患者的总生存期和无病生存期方面均表现出明显不良预后。多变量分析显示，治疗前低淋巴细胞与单核细胞比率水平、存在病理性淋巴结转移（ypN（+））和治疗前高血清C反应蛋白水平是总生存期和无病生存期的独立预后因素。此外，按 ypN 状态分为 2 组的事件发生时间分析显示，不仅在 ypN (-) 组中，而且在 ypN (+) 组中，低预处理淋巴细胞与单核细胞比率与较差的总生存期和无病生存率相关。 局限性：本研究有一些局限性，包括它是一项针对日本患者的回顾性观察性和单一机构研究。结论：淋巴细胞与单核细胞比率和ypN 状态可以作为接受术前放化疗的直肠癌患者预后不良和复发的预测标志物。请参阅 https://links 上的视频摘要。 lww。 com/DCR/A780。
BACKGROUND:Despite advances in local control of rectal cancer, recurrence in distant organs is still one of the main causes of mortality. Prognostic biomarkers would be valuable for the treatment of patients who have rectal cancer.OBJECTIVE:The aim of our study was to investigate the prognostic impact of lymphocyte-to-monocyte ratio in patients with rectal cancer receiving preoperative chemoradiotherapy, and to clarify the clinical significance of lymphocyte-to-monocyte ratio.DESIGN:Prospectively maintained data of patients with rectal cancer were retrospectively evaluated to clarify the clinical relevance of the lymphocyte-to-monocyte ratio.SETTING:This study was conducted at a single expert center.PATIENTS:A total of 119 consecutive patients with rectal cancer through chemoradiotherapy followed by total mesorectal excision at our institute were enrolled in this study. Eight patients were excluded because of a lack of laboratory data, and finally 111 patients were assessed in this study.MAIN OUTCOME MEASURES:The primary outcome measured was the clinical relevance of the lymphocyte-to-monocyte ratio in patients with rectal cancer receiving chemoradiotherapy.RESULTS:Patients with a low pretreatment lymphocyte-to-monocyte ratio showed poor prognosis significantly both in overall survival and disease-free survival of those with rectal cancer receiving chemoradiotherapy. Multivariate analyses showed that low pretreatment lymphocyte-to-monocyte ratio level, presence of pathological lymph node metastasis (ypN (+)), and high pretreatment serum C-reactive protein level were independent prognostic factors of overall survival and disease-free survival. In addition, time-to-event analysis divided into 2 groups by ypN status showed that low pretreatment lymphocyte-to-monocyte ratio was correlated with poor overall survival and disease-free survival not only in group ypN (–) but also in group ypN (+).LIMITATIONS:The present study had several limitations, including that it was a retrospective observational and single institutional study with Japanese patients.CONCLUSIONS:The combination of lymphocyte-to-monocyte ratio and ypN status can be a predictive marker of poor prognosis and recurrence among patients with rectal cancer undergoing preoperative chemoradiotherapy. See Video Abstract at https://links. lww. com/DCR/A780.