The prognostic value of the lymphocyte-to-monocyte ratio for high-risk papillary thyroid carcinoma
The prognostic value of the lymphocyte-to-monocyte ratio for high-risk papillary thyroid carcinoma
复制标题
淋巴细胞与单核细胞比值对高危甲状腺乳头状癌的预后价值
DOI：
10.2147/cmar.s219163
复制
发表时间：
2019-01-01
影响因子：
3.3
通讯作者：
Lei, Jianyong
中科院分区：
文献类型：
--
作者：
Song, Linlin;Zhu, Jingqiang;Lei, Jianyong
背景与目的乳头状甲状腺癌(PTC)的预后是高度可变的，即使是高危病例也是如此。淋巴细胞与单核细胞比率(LMR)在其他癌症中的预测和预后作用已有报道。本研究的目的是探讨LMR对高危PTC患者预后的预测价值。患者与方法将西区中国医院224例PTC高危患者随机分为训练组和测试组，上锦南府医院48例为外部验证组。结果术前LMR越低，肿瘤体积越大，N和M分期越高，训练、测试和验证集合中的多个PTC病例数越多(三组均为P<；0.05)。在训练、测试、验证和组合集合中，与低LMR患者相比，高LMR患者的总体和无PTC生存率显著提高(在单独和联合集合中均P<；0.05)。此外，多变量分析表明，LMR是影响总体和无PTC生存率的独立预后因素。根据训练集中的危险因素建立了预测5年死亡率和PTC复发的诺模图，并在独立的测试和验证集中进行了验证。结论术前LMR是一个独立的预后因素，可以与其他危险因素合并到这两张图中来预测患者的总体生存时间和无PTC生存时间。
Background and Aims The prognosis of papillary thyroid carcinoma (PTC) is highly variable, even for high-risk cases. The predictive and prognostic role of the lymphocyte-to-monocyte ratio (LMR) has been reported in other cancers. The aim of our present study was to explore the value of LMR prognostic prediction in high-risk PTC patients. Patients and Methods Two hundred and twenty-four PTC high-risk cases at West China Hospital were randomized into a training set (112 cases) and testing set (112 cases), while 48 cases in Shang Jin Nan Fu Hospital were included as the external validation set. Results A lower preoperative LMR correlated with larger tumor size, advanced N and M stages, and an increased number of multiple PTC cases in the training, testing, and validation sets (all P<0.05 in the three sets). Patients with a high LMR exhibited significantly improved overall and PTC-free survival compared with those of patients with a low LMR in the training, testing, validation, and combined sets (all P<0.05 in the individual and combined sets). Moreover, multivariate analyses identified the LMR as an independent prognostic factor for overall and PTC-free survival. The nomograms for predicting the 5-year mortality and PTC recurrence were developed based on the risk factors in the training set and validated in the independent testing and validation sets. Conclusion The preoperative LMR was identified as an independent prognostic factor that could be incorporated into the two nomograms with other risk factors to predict overall survival and PTC-free survival for individual patients.