外周血淋巴细胞绝对值和单核细胞绝对值的比值对胃癌患者预后的预测价值

Effect of peripheral blood lymphocyte-to-monocyte ratio on the prognosis of gastric cancer patients

目的探讨外周血淋巴细胞绝对值(ALC)与单核细胞绝对值(AMC)的比值(LMR)对胃癌患者预后的预测价值。方法选择接受胃癌根治术治疗的110例胃癌患者,采用Cox比例风险回归模型对可能影响患者预后的因素进行单因素及多因素分析。通过受试者工作特征(ROC)曲线确定术前外周血ALC、AMC、LMR预测胃癌患者总生存期的最佳临界值,根据LMR最佳临界值将患者分为低LMR组和高LMR组,比较两组患者的5年生存率和5年无病生存率。结果ROC曲线分析结果显示,ALC和AMC预测胃癌患者总生存期的最佳临界值分别为1.73×109/L[曲线下面积(AUC)为0.661,P﹤0.01]和0.63×109/L(AUC为0.605,P﹤0.05),LMR预测胃癌患者总生存期的最佳临界值为3.9(AUC为0.870,P﹤0.01)。Cox比例风险回归分析结果显示,TNM分期和LMR均是胃癌患者预后的独立影响因素(P﹤0.01)。高LMR组和低LMR组胃癌患者的5年生存率分别为51.2%和18.5%,差异有统计学意义(P﹤0.05);高LMR组和低LMR组胃癌患者的5年无病生存率分别为42.6%和16.2%,差异有统计学意义(P﹤0.05)。结论LMR对胃癌患者的预后评估具有一定的指导意义,可作为胃癌患者预后预测的指标。

Objective To investigate the prognostic significance of absolute lymphocyte count(ALC)to absolute monocyte count(AMC)ratio(lymphocyte-to-monocyte ratio,LMR)in patients with gastric cancer.Method 110 patients with gastric cancer who underwent radical gastrectomy were selected.Cox proportional hazard regression model was used to analyze the factors that may affect the prognosis of patients.Preoperative ALC,AMC and LMR in peripheral blood were used to determine the optimal threshold for predicting the overall survival of patients with gastric cancer by receiver operating characteristic(ROC)curve.The patients were divided into the low LMR group and the high LMR group according to the optimum critical value of LMR.The 5-year survival rate and 5-year disease-free survival rate were compared between the two groups.Result The ROC curve results showed that the optimum critical values of ALC and AMC to predict the survival of gastric cancer patients were 1.73×10^9/L[area under curve(AUC)was 0.661,P<0.01]and 0.63×10^9/L(AUC was 0.605,P<0.05),and the optimum critical value of LMR was 3.9(AUC was 0.870,P<0.01).Cox proportional risk regression analysis results showed that TNM staging and LMR were independent prognostic factors in patients with gastric cancer(P<0.01).The 5-year survival rates of gastric cancer patients in the high LMR group and the low LMR group were 51.2%and 18.5%,respectively,with significant difference(P<0.05).The 5-year disease-free survival rates of gastric cancer patients in the high LMR group and the low LMR group were 42.6%and 16.2%,respectively,with significant difference(P<0.05).Conclusion The LMR has prognostic significance for gastric cancer patients.It can be used as an index for prognosis prediction of gastric cancer patients.