A Low Lymphocyte-to-Monocyte Ratio Predicts Unfavorable Prognosis in Pathological T3N0 Rectal Cancer Patients Following Total Mesorectal Excision.
A Low Lymphocyte-to-Monocyte Ratio Predicts Unfavorable Prognosis in Pathological T3N0 Rectal Cancer Patients Following Total Mesorectal Excision.
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低淋巴细胞与单核细胞比率预示着全直肠系膜切除后病理性 T3N0 直肠癌患者的不良预后。
DOI：
10.7150/jca.11727
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发表时间：
2015
影响因子：
3.9
通讯作者：
Gao YH
中科院分区：
文献类型：
--
作者：
Xiao WW;Zhang LN;You KY;Huang R;Yu X;Ding PR;Gao YH
新辅助放化疗后行全直肠系膜切除术（TME）是II期和III期直肠癌的标准治疗选择。然而，对于接受TME的pT 3 N 0直肠癌患者，缺乏有效的方法来预测其预后，阻碍了术后治疗。低淋巴细胞与单核细胞比率（LMR）与某些恶性肿瘤的不良预后相关;然而，这种相关性尚未在直肠癌中进行研究。本研究的目的是评估LMR是否可以预测pT 3 N 0直肠癌患者TME后的预后。方法回顾性分析2004年6月至2011年11月中山大学附属肿瘤防治中心收治的直肠癌根治性全直肠系膜切除术患者。获得术前外周血绝对淋巴细胞和单核细胞的计数，并用于计算LMR。招募了280例接受TME的pT 3 N 0直肠癌患者的回顾性队列。使用单变量和多变量分析（分别为P=0.01和P=0.015），可以观察到LMR水平较低（<3.78）的患者的无病生存率显著更差。在癌胚抗原（CEA）升高且LMR <3.78的患者中进行的亚组分析显示，累积5年疾病失败率约为40%，而CEA正常（不考虑LMR）的患者和LMR ≥3.78的患者的累积5年疾病失败率仅约为15%。术前低外周LMR对pT 3 N 0直肠癌患者的预后明显不利，尤其是CEA升高的患者。这个容易获得的变量可能作为一个有价值的指标，预测pT 3 N 0直肠癌的结果，并指示适当的术后管理。
Neoadjuvant radio-chemotherapy followed by total mesorectal excision (TME) is the standard treatment option for stage II and III rectal cancer. However, for pT3N0 rectal cancer patients who receive upfront TME, the lack of an efficient method to predict their prognosis hampers postoperative treatment. A low lymphocyte-to-monocyte ratio (LMR) is associated with an unfavorable prognosis for certain malignancies; however, this association has not been investigated in rectal cancer. The purpose of this study was to evaluate whether LMR can predict the prognosis of pT3N0 rectal cancer patients following TME. Rectal cancer patients who received radical TME without preoperative treatment between June 2004 and Nov. 2011 at the Sun Yat-sen University Cancer Center were retrospectively reviewed. Counts for pre-surgery peripheral absolute lymphocytes and monocytes were obtained and used to calculate the LMR. A retrospective cohort of 280 pT3N0 rectal cancer patients who received TME was recruited. Significantly worse disease-free survival can be observed in patients with lower LMR levels (<3.78) using univariate and multivariate analyses (P=0.01 and P=0.015, respectively). Subgroup analysis in patients with elevated carcinoembryonic antigen (CEA) and LMR <3.78 exhibited an accumulated 5-year disease failure rate of approximately 40%, whereas patients with normal CEA regardless of LMR and patients with LMR ≥3.78 exhibited accumulated 5-year disease failure rates of only approximately 15%. Low pre-surgery peripheral LMR was significantly unfavorable for pT3N0 rectal cancer patient prognosis, especially in patients with elevated CEA. This easily obtained variable might serve as a valuable marker to predict the outcomes of pT3N0 rectal cancer and indicate appropriate postoperative management.
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影响因子：
8.8
作者：
Schmidt, H;Bastholt, L;Geertsen, P;Christensen, I;Larsen, S;Gehl, J;von der Maase, H
通讯作者：
von der Maase, H
影响因子：
24.5
作者：
Chew V;Chen J;Lee D;Loh E;Lee J;Lim KH;Weber A;Slankamenac K;Poon RT;Yang H;Ooi LL;Toh HC;Heikenwalder M;Ng IO;Nardin A;Abastado JP
通讯作者：
Abastado JP
影响因子：
6.4
作者：
Szkandera, Joanna;Gerger, Armin;Pichler, Martin
通讯作者：
Pichler, Martin
影响因子：
10.1
作者：
Tadmor, Tamar;Bari, Alessia;Polliack, Aaron
通讯作者：
Polliack, Aaron
影响因子：
--
作者：
Lin, Gui-Nan;Peng, Jie-Wen;Chen, Xiao-Qin
通讯作者：
Chen, Xiao-Qin