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
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
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.
基金山西省科技创新团队(201605D131044-05)山西省应用基础研究项目(201601D202094)+3 种基金山西医科大学大学生创新创业校级项目(20172116)supported by Science and Technology Innovation Team of Shanxi Province(201605D131044-05)Applied to Basic Research of Shanxi Province(201601D202094)University Innovation and Entrepreneurship School-level Project of Shanxi Medical College(20172116)
文摘目的通过分析慢性淋巴细胞白血病(chronic lymphocytic leukemia,CLL)患者的临床、实验室及随访资料探讨外周血单核细胞绝对计数(absolute monocyte count,AMC)对CLL的预后价值。方法对2002年1月至2017年12月收住山西医科大学第二医院的54例慢性淋巴细胞白血病患者的临床特点、实验室检查、治疗效果、预后进行分析,探讨影响CLL的预后因素。结果 54例患者中,男女比例为2∶1,中位年龄为64岁;其中Binet A期8例,B期25例,C期21例;以疾病进展作为终点得到外周血AMC的受试者工作特征(receiver operating characteristics,ROC)曲线,AMC的截点值为0.67×109/L,曲线的最佳灵敏度为0.710,特异度为0.783,曲线下面积(area under the curve,AUC)为0.771(95%CI:0.644~0.899)。以0.67×109/L为界限,分为高AMC组和低AMC组,低AMC组的患者无进展生存期优于高AMC组(P<0.05),但高AMC组与低AMC组之间总生存期差异无统计学意义(P=0.170)。Cox回归结果表明疾病分期为C期(P=0.038)是总生存期的独立影响因素,AMC>0.67×109/L(P=0.004)及疾病分期为C期(P=0.049)是无进展生存期的独立影响因素。结论初诊时较高的AMC与CLL较快的疾病进展有关,可能为CLL的预后判断提供新依据。
