淋巴细胞与单核细胞和中性粒细胞之和的比值对转移性结直肠癌患者预后的预测价值

Prognostic Value of the Lymphocyte-to-Sum-of-Monocyte-and-Neutrophil Ratio in Metastatic Colorectal Cancer

目的:探讨在以FOLFIRI方案一线化疗的转移性结直肠癌患者中,化疗前外周血的淋巴细胞与单核细胞和中性粒细胞之和的比值(LTMNR)对于临床预后的预测价值。方法:我们记录了化疗前的血细胞计数。LTMNR的分界值由时间依赖的受试者工作特征曲线(ROC)分析确定。生存曲线由Kaplan-Meier方法获得。指标的独立预测作用由基于Cox回归模型的多因素分析来确定。结果:在125例患者中,小于分界值的LTMNR与较短的无进展生存期(PFS)相关(12.3月vs 7.9月,P=0.003),与较短的总生存期(OS)相关(29.6月vs 18.0月,P=0.016)。在多因素分析中,LTMNR较低的患者疾病进展风险[风险比(HR)=3.025;95%置信区间(CI)=1.627-5.626;P<0.001]和死亡风险(HR=3.226;95%CI=1.511-6.891;P=0.002)均比LTMNR较高者升高。结论:LTMNR是中国人群中接受FOLFIRI方案一线化疗的转移性结直肠癌患者的独立的预后因素,LTMNR较低的患者不论PFS还是OS均短于LTMNR较高的患者。

Objective：To investigate the prognostic value of the circulating lymphocyte-to-sum-of-monocyte-and-neutrophil ratio（LTMNR）prior to the commencement of chemotherapy in predicting the clinical outcome of metastatic colorectal cancer（mCRC）in patients undergoing FOLFIRI first-line chemotherapy.Methods：Baseline complete blood cell counts were performed.The optimal cutoff value for LTMNR was determined by using time-dependent receiver operating characteristic curve（ROC）analysis.Survival was determined by the Kaplan-Meier method.Multivariate analyses based on the Cox regression model were performed to determine the effects independent biomarker.Results：Among the 125 patients,a LTMNR lower than the cutoff value was associated with worse progression-free survival（PFS）（12.3 vs 7.9months,P=0.003）and overall survival（OS）（29.6 vs 18.0months,P=0.016）.In the multivariate analysis,individuals with a lower LTMNR had an increased risk of disease progression（hazard ratio [HR],3.025;95%confidence interval[CI],1.627-5.626;P〈0.001）and death（HR,3.226;95% CI,1.511-6.891;P=0.002）,compared with individuals with a higher LTMNR.Conclusions：LTMNR is an independent prognostic marker of mCRC treated with first-line FOLFIRI regimen in the Chinese population,and a lower LTMNR is predictive of worse PFS and OS.