AIM:To measure the prognostic significance of absolute monocyte count/absolute lymphocyte count prognostic score(AMLPS) in patients with gastric cancer.METHODS:We retrospectively examined the combination of absolute m...AIM:To measure the prognostic significance of absolute monocyte count/absolute lymphocyte count prognostic score(AMLPS) in patients with gastric cancer.METHODS:We retrospectively examined the combination of absolute monocyte count(AMC) and absolute lymphocyte count(ALC) as prognostic variables in a cohort of 299 gastric cancer patients who underwent surgical resection between 2006 and 2013 and were followed at a single institution.Both AMC and ALC were dichotomized into two groups using cut-off points determined by receiving operator characteristic curve analysis.An AMLPS was generated,which stratified patients into three risk groups:low risk(both low AMC and high ALC),intermediate risk(either high AMC or low ALC),and high risk(both high AMC and low ALC).The primary objective of the study was to validate the impact of AMLPS on both disease-free survival(DFS) and overall survival(OS),and the second objective was to assess the AMLPS as an independent prognostic factor for survival in comparison with known prognostic factors.RESULTS:Using data from the entire cohort,the most discriminative cut-off values of AMC and ALC selected on the receiver operating characteristic curve were 672.4/μL and 1734/μL for DFS and OS.AMLPS risk groups included 158(52.8%) patients in the lowrisk,128(42.8%) in the intermediate-risk,and 13(4.3%) in the high-risk group.With a median followup of 37.2 mo(range:1.7-91.4 mo),five-year DFS rates in the low-,intermediate-,and high-risk groups were 83.4%,78.7%,and 19.8%,respectively.And fiveyear OS rates in the low-,intermediate-,and high-risk groups were 89.3%,81.1%,and 14.4%,respectively.On multivariate analysis performed with patient- and tumor-related factors,we identified AMLPS,age,and pathologic tumor-node-metastasis stage as the most valuable prognostic factors impacting DFS and OS.CONCLUSION:AMLPS identified patients with a poor DFS and OS,and it was independent of age,pathologic stage,and various inflammatory markers.展开更多
AIM To examine the optimal absolute lymphocyte count(ALC) cut-off utilizing receiver operator characteristics(ROC) in addition to graft characteristics associated with early ALC recovery.METHODS Patients who received ...AIM To examine the optimal absolute lymphocyte count(ALC) cut-off utilizing receiver operator characteristics(ROC) in addition to graft characteristics associated with early ALC recovery.METHODS Patients who received T-cell replete peripheral hematopoietic cell transplantation(HCT) for acute leukemia were identified. ALC cut-off was established using ROC analysis and subsequently the cohort was stratified. Time to endpoint analysis and cox regression modelling was computed to analyze outcomes. RESULTS A total of 72 patients met the inclusion criteria andwere analyzed. Optimal ALC cut-off was established to be on day 14(D14) with ALC > 0.3 × 10~9/L. At 2 years, cumulative incidence of relapse was 16.9% vs 46.9%(P = 0.025) for early and delayed lymphocyte recovery cohorts, respectively. Chronic graft vs host disease was more prevalent in the early lymphocyte recovery(ELR) group at 70% vs 27%, respectively(P = 0.0006). On multivariable analysis for relapse, ELR retained its prognostic significance with HR = 0.27(0.05-0.94, P = 0.038).CONCLUSION ELR is an independent predictor for relapse in patients receiving allogeneic HCT for acute leukemia. ELR was influenced by graft characteristics particularly CD34 count.展开更多
Background and objective: During routine follow up, there is no specific predictor to ascertain relapse after standard first line chemotherapy in diffuse large cell lymphoma. Therefore, this study was designed to asse...Background and objective: During routine follow up, there is no specific predictor to ascertain relapse after standard first line chemotherapy in diffuse large cell lymphoma. Therefore, this study was designed to assess the prognostic significance of the ratio between absolute lymphocyte and monocyte counts (LMR) in the peripheral blood to verify relapse in diffuse large B cell lymphoma. Patients and methods: A total of 139 patients with newly diagnosed diffuse large B cell lymphoma (DLBCL) were evaluated and treated with CHOP or R-CHOP between the years 2009 and 2016. Three months following completion of first line therapy, Lymphocyte/monocyte ratio (LMR) was calculated from the routine automated complete blood cell count (CBC) attained a plateau after the bone marrow recovery after first line chemotherapy. The absolute lymphocyte count/absolute monocyte count ratio (LMR) was calculated by dividing the ALC by the AMC. Results: ROC curve analysis of 139 patients established 2.8 as cutoff point of LMR for relapse with AUC of 0.97 (95% CI 0.93 - 0.99, P ≤ 0.001). Cox regression analysis was performed to identify factors predicting relapse. In univariate regression analysis, ALC (95% CI 0.003 - 0.03, p ≤ 0.001), AMC (95% CI 15.4 - 128.8, p ≤ 0.001), LMR (95% CI 0.001 - 0.01, p ≤ 0.001), and LDH (95% CI 0.1 - 0.5, p ≤ 0.001) following completion of therapy are significant factors for relapse. Other significant factors for relapse are Ann Arbor stage (95% CI 1.1 - 6.9, P = 0.03), extranodal sites (95% CI 1.2 - 6.1, P = 0.01), age (95% CI 1.3 - 6.5, P = 0.01) and treatment of CHOP protocol (95% CI 0.05 - 0.6, P = 0.007). In a multivariate analysis LMR following completion of therapy was predictive for relapse (95% CI 0.001 - 0.2, P = 0.005). ALC was also significant in multivariate analysis (95% CI 0.01 - 0.8, P = 0.03). LDH following completion of therapy (95% CI 0.2 - 14.9, P = 0.5), AMC following completion of therapy (95% CI 0.3 - 43.1, P = 0.3), age (95% CI 0.9 - 205.4, P = 0.06), extra-nodal sites (95% CI 0.04 - 9.8, P = 0.8), Ann Arbor stage (95% CI 0.3 - 28.7, P = 0.3), and Treatment of CHOP protocol (95% CI 0.01 - 2.4, P = 0.2) were not statistically significant. Conclusion: This study observed that LMR assessed after first line chemotherapy during routine follow up is an independent predictor of relapse and clinical outcome in DLBCL patients. LMR at follow up can be used a simple inexpensive biomarker to alert clinicians for relapse during follow up after standard first line chemotherapy in DLBCL patients.展开更多
目的应用Bland-Altman法评价国产与进口绝对计数管检测外周血淋巴细胞亚群绝对计数结果的一致性。方法选取80例外周血样本,以进口绝对计数管为对照产品,对两种国产绝对计数管进行流式细胞术CD3^(+)和CD3^(+)CD4^(+)淋巴细胞检测,采用D’...目的应用Bland-Altman法评价国产与进口绝对计数管检测外周血淋巴细胞亚群绝对计数结果的一致性。方法选取80例外周血样本,以进口绝对计数管为对照产品,对两种国产绝对计数管进行流式细胞术CD3^(+)和CD3^(+)CD4^(+)淋巴细胞检测,采用D’Agostino&Pearson正态性检验及回归分析对检测结果的差值进行随机性、同方差性和正态性分析,应用Bland-Altman法和线性回归分析一致性和相关性,并采用中、低浓度细胞质控品评估检测结果的精密度。结果判定两种国产与进口绝对计数管检测CD3^(+)、CD3^(+)CD4^(+)淋巴细胞绝对计数的差值为数据行为不良,故对检测结果的比值采用比值Bland-Altman法分析,结果显示95%一致性界限(limits of agreement,LoA)上下限的95%置信区间(confidence interval,CI)内的点在临床可接受一致性界线内,一致性良好。线性回归分析显示,国产与进口绝对计数管检测CD3^(+)、CD3^(+)CD4^(+)淋巴细胞绝对计数的结果高度相关,均可建立回归方程(P<0.001)。对中、低浓度细胞质控品各进行12次重复试验,结果显示中值的CD3^(+)、CD3^(+)CD4^(+)淋巴细胞绝对计数结果CV值不大于4.13%,低值的CD3^(+)、CD3^(+)CD4^(+)淋巴细胞绝对计数结果CV值不大于6.86%,均具有较好重复性。结论使用国产与进口绝对计数管检测外周血CD3^(+)和CD3^(+)CD4^(+)淋巴细胞绝对计数,其检测结果具有良好一致性,临床实验室可根据需求选择国产品牌替代进口产品使用。展开更多
目的探讨胸腺指数及外周血绝对淋巴细胞计数(ALC)与感染性肺炎新生儿预后的关系。方法回顾性分析203例感染性肺炎新生儿的临床资料。根据预后将患儿分为预后不良组和预后良好组。比较两组患儿的一般临床资料、胸腺指数、外周血ALC。采...目的探讨胸腺指数及外周血绝对淋巴细胞计数(ALC)与感染性肺炎新生儿预后的关系。方法回顾性分析203例感染性肺炎新生儿的临床资料。根据预后将患儿分为预后不良组和预后良好组。比较两组患儿的一般临床资料、胸腺指数、外周血ALC。采用多因素Logistic回归模型分析感染性肺炎新生儿预后的影响因素。采用受试者工作特征(ROC)曲线分析胸腺指数、外周血ALC单独及联合预测感染性肺炎新生儿预后不良的效能。结果203例患儿中,共42例预后不良(预后不良组),共161例预后良好(预后良好组),预后不良发生率为20.69%。预后不良组患儿出生后1 min Apgar评分≤7分占比、新生儿重症监护病房住院时间、肺部超声评分、治疗前血清白细胞介素6(IL-6)和降钙素原水平高于或长于预后良好组,胸腺指数、外周血ALC低于预后良好组(P<0.05)。多因素Logistic回归分析结果显示,出生后1 min Apgar评分、肺部超声评分、治疗前血清降钙素原水平增加是感染性肺炎新生儿预后不良的独立危险因素,胸腺指数、外周血ALC增加则是保护因素(P<0.05)。ROC曲线分析结果显示,胸腺指数、外周血ALC单独及联合预测感染性肺炎新生儿预后不良的曲线下面积分别为0.816、0.800、0.890,二者联合预测的曲线下面积大于胸腺指数、外周血ALC单独预测的曲线下面积(P<0.05)。结论胸腺指数、外周血ALC降低可增加感染性肺炎新生儿预后不良的发生风险。二者对此类患儿的预后具有一定的预测效能,且二者联合应用时预测效能较高。展开更多
Background：The absolute lymphocyte counts （ALCs） have been reported as one of worse prognostic factors for hepatocellular carcinoma （HCC） patient after liver transplantation.The aim of this study was to assess th...Background：The absolute lymphocyte counts （ALCs） have been reported as one of worse prognostic factors for hepatocellular carcinoma （HCC） patient after liver transplantation.The aim of this study was to assess the influence of ALCs on the outcomes of patients with hepatitis B virus （HBV）-related HCC within the Milan criteria following liver resection.Methods：Data of patients with HCC within the Milan criteria who received liver resection between January 2007 and June 2013 were reviewed,and perioperative ALCs were carefully monitored.All potential risk factors were statistically analyzed by uni-and multi-variate analyses.The receiver operating characteristic （ROC） curve was used to determine the optimalALCs cut-offvalue to predict HCC recurrence after liver resection.Results：A total of 221 patients were enrolled in the current study.During the follow-up period,106 patients experienced recurrence,and 38 patients died.Multivariate analysis suggested microvascular invasion （MVI）,a tumor grade ≥2,and a low postoperative ALCs in the 1^st postoperative month increased the incidence of postoperative recurrence,besides,MVI,intraoperative transfusion,and a low postoperative ALCs in the 1 st postoperative month were associated with poor overall survival （OS）.An ROC analysis showed that a cut-offvalue of 1.5 × 10^9/L for ALCs in the 1^st postoperative month predicted postoperative recurrence.The 5-year recurrence-free survival （RFS） and OS rates of patients with low postoperative ALCs were 34.5% and 64.8%,respectively,which were significantly lower than those of patients with high postoperative ALC （58.5% for RFS and 86.5% for OS）.Conclusion：Low ALCs in the 1^st postoperative month may be associated with high recurrence incidence and poor OS for patients with HBV-related HCC within the Milan criteria after liver resection.展开更多
基金Supported by Kyung Hee University in 2006,No.KHU-20061216
文摘AIM:To measure the prognostic significance of absolute monocyte count/absolute lymphocyte count prognostic score(AMLPS) in patients with gastric cancer.METHODS:We retrospectively examined the combination of absolute monocyte count(AMC) and absolute lymphocyte count(ALC) as prognostic variables in a cohort of 299 gastric cancer patients who underwent surgical resection between 2006 and 2013 and were followed at a single institution.Both AMC and ALC were dichotomized into two groups using cut-off points determined by receiving operator characteristic curve analysis.An AMLPS was generated,which stratified patients into three risk groups:low risk(both low AMC and high ALC),intermediate risk(either high AMC or low ALC),and high risk(both high AMC and low ALC).The primary objective of the study was to validate the impact of AMLPS on both disease-free survival(DFS) and overall survival(OS),and the second objective was to assess the AMLPS as an independent prognostic factor for survival in comparison with known prognostic factors.RESULTS:Using data from the entire cohort,the most discriminative cut-off values of AMC and ALC selected on the receiver operating characteristic curve were 672.4/μL and 1734/μL for DFS and OS.AMLPS risk groups included 158(52.8%) patients in the lowrisk,128(42.8%) in the intermediate-risk,and 13(4.3%) in the high-risk group.With a median followup of 37.2 mo(range:1.7-91.4 mo),five-year DFS rates in the low-,intermediate-,and high-risk groups were 83.4%,78.7%,and 19.8%,respectively.And fiveyear OS rates in the low-,intermediate-,and high-risk groups were 89.3%,81.1%,and 14.4%,respectively.On multivariate analysis performed with patient- and tumor-related factors,we identified AMLPS,age,and pathologic tumor-node-metastasis stage as the most valuable prognostic factors impacting DFS and OS.CONCLUSION:AMLPS identified patients with a poor DFS and OS,and it was independent of age,pathologic stage,and various inflammatory markers.
文摘AIM To examine the optimal absolute lymphocyte count(ALC) cut-off utilizing receiver operator characteristics(ROC) in addition to graft characteristics associated with early ALC recovery.METHODS Patients who received T-cell replete peripheral hematopoietic cell transplantation(HCT) for acute leukemia were identified. ALC cut-off was established using ROC analysis and subsequently the cohort was stratified. Time to endpoint analysis and cox regression modelling was computed to analyze outcomes. RESULTS A total of 72 patients met the inclusion criteria andwere analyzed. Optimal ALC cut-off was established to be on day 14(D14) with ALC > 0.3 × 10~9/L. At 2 years, cumulative incidence of relapse was 16.9% vs 46.9%(P = 0.025) for early and delayed lymphocyte recovery cohorts, respectively. Chronic graft vs host disease was more prevalent in the early lymphocyte recovery(ELR) group at 70% vs 27%, respectively(P = 0.0006). On multivariable analysis for relapse, ELR retained its prognostic significance with HR = 0.27(0.05-0.94, P = 0.038).CONCLUSION ELR is an independent predictor for relapse in patients receiving allogeneic HCT for acute leukemia. ELR was influenced by graft characteristics particularly CD34 count.
文摘Background and objective: During routine follow up, there is no specific predictor to ascertain relapse after standard first line chemotherapy in diffuse large cell lymphoma. Therefore, this study was designed to assess the prognostic significance of the ratio between absolute lymphocyte and monocyte counts (LMR) in the peripheral blood to verify relapse in diffuse large B cell lymphoma. Patients and methods: A total of 139 patients with newly diagnosed diffuse large B cell lymphoma (DLBCL) were evaluated and treated with CHOP or R-CHOP between the years 2009 and 2016. Three months following completion of first line therapy, Lymphocyte/monocyte ratio (LMR) was calculated from the routine automated complete blood cell count (CBC) attained a plateau after the bone marrow recovery after first line chemotherapy. The absolute lymphocyte count/absolute monocyte count ratio (LMR) was calculated by dividing the ALC by the AMC. Results: ROC curve analysis of 139 patients established 2.8 as cutoff point of LMR for relapse with AUC of 0.97 (95% CI 0.93 - 0.99, P ≤ 0.001). Cox regression analysis was performed to identify factors predicting relapse. In univariate regression analysis, ALC (95% CI 0.003 - 0.03, p ≤ 0.001), AMC (95% CI 15.4 - 128.8, p ≤ 0.001), LMR (95% CI 0.001 - 0.01, p ≤ 0.001), and LDH (95% CI 0.1 - 0.5, p ≤ 0.001) following completion of therapy are significant factors for relapse. Other significant factors for relapse are Ann Arbor stage (95% CI 1.1 - 6.9, P = 0.03), extranodal sites (95% CI 1.2 - 6.1, P = 0.01), age (95% CI 1.3 - 6.5, P = 0.01) and treatment of CHOP protocol (95% CI 0.05 - 0.6, P = 0.007). In a multivariate analysis LMR following completion of therapy was predictive for relapse (95% CI 0.001 - 0.2, P = 0.005). ALC was also significant in multivariate analysis (95% CI 0.01 - 0.8, P = 0.03). LDH following completion of therapy (95% CI 0.2 - 14.9, P = 0.5), AMC following completion of therapy (95% CI 0.3 - 43.1, P = 0.3), age (95% CI 0.9 - 205.4, P = 0.06), extra-nodal sites (95% CI 0.04 - 9.8, P = 0.8), Ann Arbor stage (95% CI 0.3 - 28.7, P = 0.3), and Treatment of CHOP protocol (95% CI 0.01 - 2.4, P = 0.2) were not statistically significant. Conclusion: This study observed that LMR assessed after first line chemotherapy during routine follow up is an independent predictor of relapse and clinical outcome in DLBCL patients. LMR at follow up can be used a simple inexpensive biomarker to alert clinicians for relapse during follow up after standard first line chemotherapy in DLBCL patients.
文摘目的应用Bland-Altman法评价国产与进口绝对计数管检测外周血淋巴细胞亚群绝对计数结果的一致性。方法选取80例外周血样本,以进口绝对计数管为对照产品,对两种国产绝对计数管进行流式细胞术CD3^(+)和CD3^(+)CD4^(+)淋巴细胞检测,采用D’Agostino&Pearson正态性检验及回归分析对检测结果的差值进行随机性、同方差性和正态性分析,应用Bland-Altman法和线性回归分析一致性和相关性,并采用中、低浓度细胞质控品评估检测结果的精密度。结果判定两种国产与进口绝对计数管检测CD3^(+)、CD3^(+)CD4^(+)淋巴细胞绝对计数的差值为数据行为不良,故对检测结果的比值采用比值Bland-Altman法分析,结果显示95%一致性界限(limits of agreement,LoA)上下限的95%置信区间(confidence interval,CI)内的点在临床可接受一致性界线内,一致性良好。线性回归分析显示,国产与进口绝对计数管检测CD3^(+)、CD3^(+)CD4^(+)淋巴细胞绝对计数的结果高度相关,均可建立回归方程(P<0.001)。对中、低浓度细胞质控品各进行12次重复试验,结果显示中值的CD3^(+)、CD3^(+)CD4^(+)淋巴细胞绝对计数结果CV值不大于4.13%,低值的CD3^(+)、CD3^(+)CD4^(+)淋巴细胞绝对计数结果CV值不大于6.86%,均具有较好重复性。结论使用国产与进口绝对计数管检测外周血CD3^(+)和CD3^(+)CD4^(+)淋巴细胞绝对计数,其检测结果具有良好一致性,临床实验室可根据需求选择国产品牌替代进口产品使用。
文摘目的探讨胸腺指数及外周血绝对淋巴细胞计数(ALC)与感染性肺炎新生儿预后的关系。方法回顾性分析203例感染性肺炎新生儿的临床资料。根据预后将患儿分为预后不良组和预后良好组。比较两组患儿的一般临床资料、胸腺指数、外周血ALC。采用多因素Logistic回归模型分析感染性肺炎新生儿预后的影响因素。采用受试者工作特征(ROC)曲线分析胸腺指数、外周血ALC单独及联合预测感染性肺炎新生儿预后不良的效能。结果203例患儿中,共42例预后不良(预后不良组),共161例预后良好(预后良好组),预后不良发生率为20.69%。预后不良组患儿出生后1 min Apgar评分≤7分占比、新生儿重症监护病房住院时间、肺部超声评分、治疗前血清白细胞介素6(IL-6)和降钙素原水平高于或长于预后良好组,胸腺指数、外周血ALC低于预后良好组(P<0.05)。多因素Logistic回归分析结果显示,出生后1 min Apgar评分、肺部超声评分、治疗前血清降钙素原水平增加是感染性肺炎新生儿预后不良的独立危险因素,胸腺指数、外周血ALC增加则是保护因素(P<0.05)。ROC曲线分析结果显示,胸腺指数、外周血ALC单独及联合预测感染性肺炎新生儿预后不良的曲线下面积分别为0.816、0.800、0.890,二者联合预测的曲线下面积大于胸腺指数、外周血ALC单独预测的曲线下面积(P<0.05)。结论胸腺指数、外周血ALC降低可增加感染性肺炎新生儿预后不良的发生风险。二者对此类患儿的预后具有一定的预测效能,且二者联合应用时预测效能较高。
文摘Background：The absolute lymphocyte counts （ALCs） have been reported as one of worse prognostic factors for hepatocellular carcinoma （HCC） patient after liver transplantation.The aim of this study was to assess the influence of ALCs on the outcomes of patients with hepatitis B virus （HBV）-related HCC within the Milan criteria following liver resection.Methods：Data of patients with HCC within the Milan criteria who received liver resection between January 2007 and June 2013 were reviewed,and perioperative ALCs were carefully monitored.All potential risk factors were statistically analyzed by uni-and multi-variate analyses.The receiver operating characteristic （ROC） curve was used to determine the optimalALCs cut-offvalue to predict HCC recurrence after liver resection.Results：A total of 221 patients were enrolled in the current study.During the follow-up period,106 patients experienced recurrence,and 38 patients died.Multivariate analysis suggested microvascular invasion （MVI）,a tumor grade ≥2,and a low postoperative ALCs in the 1^st postoperative month increased the incidence of postoperative recurrence,besides,MVI,intraoperative transfusion,and a low postoperative ALCs in the 1 st postoperative month were associated with poor overall survival （OS）.An ROC analysis showed that a cut-offvalue of 1.5 × 10^9/L for ALCs in the 1^st postoperative month predicted postoperative recurrence.The 5-year recurrence-free survival （RFS） and OS rates of patients with low postoperative ALCs were 34.5% and 64.8%,respectively,which were significantly lower than those of patients with high postoperative ALC （58.5% for RFS and 86.5% for OS）.Conclusion：Low ALCs in the 1^st postoperative month may be associated with high recurrence incidence and poor OS for patients with HBV-related HCC within the Milan criteria after liver resection.
