The preoperative lymphocyte to monocyte ratio predicts clinical outcome in patients with stage III colon cancer.

The preoperative lymphocyte to monocyte ratio predicts clinical outcome in patients with stage III colon cancer.
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DOI:
10.1038/bjc.2013.785
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发表时间:
2014-01-21
影响因子:
8.8
通讯作者:
Gerger, A.
Gerger, A.
中科院分区:
医学1区
文献类型:
--
作者:
Stotz, M.;Pichler, M.;Absenger, G.;Szkandera, J.;Arminger, F.;Schaberl-Moser, R.;Samonigg, H.;Stojakovic, T.;Gerger, A.

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炎症在癌症的发病机制和进展中起着至关重要的作用。淋巴细胞与单核细胞比率(LMR)可显示血液肿瘤的预后。在这项研究中,我们分析了 II 期和 III 期结肠癌患者的 LMR 与临床结果。这项回顾性研究纳入了 372 名 II 期和 III 期结肠癌患者。通过 Kaplan-Meier 曲线和多变量 Cox 回归分析计算复发时间 (TTR) 和总生存期 (OS)。包括所有患者在内,多变量分析显示,术前 LMR 升高与 TTR 和 OS 升高显着相关(HR:0.47,95%CI:0.29-0.76,P=0.002;HR:0.51,95%CI:0.31-0.83,P=0.007)。在亚组分析中,这种关联仅限于 III 期患者(HR:0.40,95%CI:0.22-0.72,P=0.002),而 II 期患者(HR:0.40,95%CI:0.28-1.66,P=0.397)则相反。当分析“高危”LMR≥2.83 的患者亚组时,未发现基于 5-FU 的辅助化疗有任何益处(HR:0.99;95%CI:0.60-1.63;P=0.953)。 LMR 可能是 III 期结肠癌患者 TTR 的独立预后标志物。我们的结果进一步表明,基于 LMR 的高危患者不会从辅助化疗中受益。我们的研究结果有必要进行独立验证。
Inflammation has a critical role in the pathogenesis and progression of cancer. The lymphocyte to monocyte ratio (LMR) could be shown to be prognostic in haematologic neoplasia. In this study, we analysed the LMR with clinical outcome in stage II and III colon cancer patients. Three hundred and seventy-two patients with stage II and III colon cancer were included in this retrospective study. Kaplan–Meier curves and multivariate Cox-regression analyses were calculated for time to recurrence (TTR) and overall survival (OS). Including all patients, the elevated preoperative LMR was significantly associated with increased TTR and OS in multivariate analysis (HR: 0.47, 95%CI: 0.29–0.76, P=0.002; HR: 0.51, 95%CI: 0.31–0.83, P=0.007; respectively). In subanalyses, the association was limited to patients with stage III (HR: 0.40, 95%CI: 0.22–0.72, P=0.002), in contrast to patients with stage II (HR: 0.40, 95%CI: 0.28–1.66, P=0.397). When the subgroup of patients with ‘high-risk' LMR⩽2.83 was analysed, no benefit of adjuvant 5-FU-based chemotherapy could be found (HR: 0.99; 95%CI: 0.60–1.63; P=0.953). The LMR might be an independent prognostic marker for TTR in stage III colon cancer patients. Our results further suggest that high-risk patients based on the LMR do not benefit from adjuvant chemotherapy. Independent validation of our findings is warranted.
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