Baseline and Trend of Lymphocyte-to-Monocyte Ratio as Prognostic Factors in Epidermal Growth Factor Receptor Mutant Non-Small Cell Lung Cancer Patients Treated with First-Line Epidermal Growth Factor Receptor Tyrosine Kinase Inhibitors.
Baseline and Trend of Lymphocyte-to-Monocyte Ratio as Prognostic Factors in Epidermal Growth Factor Receptor Mutant Non-Small Cell Lung Cancer Patients Treated with First-Line Epidermal Growth Factor Receptor Tyrosine Kinase Inhibitors.
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DOI：
10.1371/journal.pone.0136252
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发表时间：
2015
期刊：
影响因子：
3.7
通讯作者：
Lin MC
中科院分区：
文献类型：
--
作者：
Chen YM;Lai CH;Chang HC;Chao TY;Tseng CC;Fang WF;Wang CC;Chung YH;Wang YH;Su MC;Huang KT;Chen HC;Chang YC;Lin MC
具有高基线淋巴细胞与单核细胞比率（LMR）的早期肺癌患者具有良好的预后。然而，LMR在接受一线表皮生长因子受体（EGFR）-酪氨酸激酶抑制剂（TKI）治疗的晚期EGFR突变型非小细胞肺癌（NSCLC）患者中的预后意义尚未确定。我们进行了一项回顾性分析，研究LMR对EGFR突变型NSCLC患者的临床结局（包括无进展生存期（PFS）和总生存期（OS））的影响。在2011年1月至2013年10月期间诊断的1310例肺癌患者中，纳入了253例接受EGFR突变型NSCLC一线EGFR-TKI治疗的患者。使用受试者工作特征曲线确定的基线LMR和1个月与基线比值（MBR）的截止值分别为3.29和0.63。患者分为3个预后组：高LMR和MBR，高LMR或MBR，低LMR和MBR。患者平均年龄为65.2岁，41%为男性。中位PFS和OS分别为10.3和22.0个月。高LMR和MBR、高LMR或MBR和低LMR和MBR患者的PFS分别为15.4、7.1和2.0个月（p < 0.001），而OS分别为32.6、13.7和5.1个月（p < 0.001）。基线和LMR趋势的组合可用于识别接受一线EGFR-TKI治疗的EGFR突变型NSCLC患者中具有高死亡风险的患者。
Patients with early-stage lung cancer who have a high baseline lymphocyte-to-monocyte ratio (LMR) have a favorable prognosis. However, the prognostic significance of LMR in patients with advanced-stage EGFR-mutant non-small cell lung cancer (NSCLC) receiving first-line epidermal growth factor receptor (EGFR)-tyrosine kinase inhibitors (TKIs) has not been established. We conducted a retrospective analysis to investigate the influence of LMR on clinical outcomes including progression-free survival (PFS) and overall survival (OS) in EGFR-mutant patients with NSCLC. Of 1310 lung cancer patients diagnosed between January 2011 and October 2013, 253 patients receiving first-line EGFR-TKIs for EGFR-mutant NSCLC were included. The cut-off values for baseline and the 1-month-to-baseline ratio of LMR (MBR), determined by using receiver operating characteristic curves, were 3.29 and 0.63, respectively. Patients were divided into 3 prognostic groups: high LMR and MBR, high LMR or MBR, and low LMR and MBR. The mean patient age was 65.2 years, and 41% were men. The median PFS and OS were 10.3 and 22.0 months, respectively. The PFS in patients with high LMR and MBR, high LMR or MBR, and low LMR and MBR were 15.4, 7.1, and 2.0 months, respectively (p < 0.001), whereas the OS were 32.6, 13.7, and 5.1 months, respectively (p < 0.001). A combination of baseline and trend of LMR can be used to identify patients with a high mortality risk in EGFR-mutant NSCLC patients receiving first-line EGFR-TKIs.