淋巴细胞与单核细胞比值在中晚期胸部肿瘤放疗患者的预后相关性分析

Prognostic correlation of lymphocyte-to-monocyte ratio in patients with middle and advanced thoracic tumors with radiotherapy

回顾性分析中晚期胸部恶性肿瘤(食管癌、肺癌)患者放疗前后淋巴细胞与单核细胞比值(Lymphocyte/monocyte ratio,LMR)的预后意义。收集2017年01月至2021年12月在江苏盛泽医院进行放射治疗的中晚期肺癌、食管癌患者的临床资料进行回顾性分析,共74例。采集患者外周放疗前、后1周内血常规,并记录LMR,建立受试者工作特征曲线(ROC)以获得总生存期(OS)最佳截断值,分析患者放疗前后LMR与预后的相关性。用Kaplan-Meier法制作总OS生存曲线,用Cox比例风险回归模型进行单因素、多因素分析。结果显示:全组中位随访时间15个月,中位年龄70岁,根据ROC曲线得到放疗前LMR最佳临界值为2.46,曲线下面积(AUC)=0.719;放疗后LMR最佳临界值为1.07,AUC=0.682。Kaplan-Meier曲线显示,放疗前后高LMR组预后均较好(p<0.05);Cox风险比例模型单因素分析显示临床分期、诊断、联合治疗与否,放疗前后LMR均与预后有关;多因素分析结果表明,临床分期、联合治疗、放疗前后LMR是中晚期肺癌、食管癌患者接受放疗后的独立预后因素(p<0.05)。提示放疗前后LMR均与中晚期胸部肿瘤患者的预后有关,高LMR组的中晚期肺癌、食管癌放疗患者的预后较好。

The purpose of this study was to retrospectively investigate the prognostic significance of the lymphocyte-to-monocyte ratio(LMR)in patients with middle and advanced thoracic malignant tumors(esophageal and lung cancer)prior to and after radiotherapy.The clinical data of 74 patients with middle-advanced stage lung and esophageal cancer who received radiotherapy in Jiangsu Shengze hospital from January 2017 to December 2021 were screened for this retrospective analysis.Peripheral blood was collected,and LMR was recorded before and within one week following radiotherapy.The receiver operating characteristic curve(ROC)was established to obtain the best cut-off value for overall survival(OS).The correlation between LMR and prognosis before and after radiotherapy was examined.The Kaplan-Meier method was used to create the survival curve,and Cox proportional hazard regression model was used for univariate and multivariate analysis.The median follow-up time was 15 months,and the median age was 70 years.According to the ROC curve,the best critical value of LMR prior to radiotherapy was 2.46,AUC=0.719,while the best critical value of LMR after radiotherapy was 1.07,AUC=0.682.The Cox risk ratio model showed that clinical stage,diagnosis,combination therapy,and LMR before and after radiotherapy were all related to prognosis.Multivariate analysis revealed that clinical stage,combination therapy,and LMR before and after radiotherapy were independent prognostic factors in patients with middle and advanced lung and esophageal cancer following radiotherapy(p<0.05).LMR before and after radiotherapy was associated with the prognosis of patients with middle and advanced thoracic tumors.Patients who accepted radiotherapy for middle and advanced lung and esophageal cancer with high LMR had a better prognosis.