1] Division of Clinical Oncology, Department of Medicine, Medical University of Graz, Auenbruggerplatz 15, 8036 Graz, Austria [2] Research Unit Genetic Epidemiology and Pharmacogenetics, Division of Clinical Oncology, Medical University of Graz, Auenbruggerplatz 15, 8036 Graz, Austria.
Division of Clinical Oncology, Department of Medicine, Medical University of Graz, Auenbruggerplatz 15, 8036 Graz, Austria.
Br J Cancer. 2014 Jan 21;110(2):435-40. doi: 10.1038/bjc.2013.785. Epub 2013 Dec 19.
Inflammation has a critical role in the pathogenesis and progression of cancer. The lymphocyte to monocyte ratio (LMR) could be shown to be prognostic in haematologic neoplasia. In this study, we analysed the LMR with clinical outcome in stage II and III colon cancer patients.
Three hundred and seventy-two patients with stage II and III colon cancer were included in this retrospective study. Kaplan-Meier curves and multivariate Cox-regression analyses were calculated for time to recurrence (TTR) and overall survival (OS).
Including all patients, the elevated preoperative LMR was significantly associated with increased TTR and OS in multivariate analysis (HR: 0.47, 95%CI: 0.29-0.76, P=0.002; HR: 0.51, 95%CI: 0.31-0.83, P=0.007; respectively). In subanalyses, the association was limited to patients with stage III (HR: 0.40, 95%CI: 0.22-0.72, P=0.002), in contrast to patients with stage II (HR: 0.40, 95%CI: 0.28-1.66, P=0.397). When the subgroup of patients with 'high-risk' LMR≤2.83 was analysed, no benefit of adjuvant 5-FU-based chemotherapy could be found (HR: 0.99; 95%CI: 0.60-1.63; P=0.953).
The LMR might be an independent prognostic marker for TTR in stage III colon cancer patients. Our results further suggest that high-risk patients based on the LMR do not benefit from adjuvant chemotherapy. Independent validation of our findings is warranted.
炎症在癌症的发病机制和进展中起着关键作用。淋巴细胞与单核细胞比值（LMR）在血液系统肿瘤中已被证明具有预后价值。在本研究中，我们分析了 LMR 与 II 期和 III 期结肠癌患者临床结局的关系。
本回顾性研究纳入了 372 例 II 期和 III 期结肠癌患者。采用 Kaplan-Meier 曲线和多因素 Cox 回归分析计算无复发生存时间（TTR）和总生存时间（OS）。
在所有患者中，术前升高的 LMR 在多因素分析中与 TTR 和 OS 的增加显著相关（HR：0.47，95%CI：0.29-0.76，P=0.002；HR：0.51，95%CI：0.31-0.83，P=0.007）。亚组分析显示，这种相关性仅限于 III 期患者（HR：0.40，95%CI：0.22-0.72，P=0.002），而与 II 期患者（HR：0.40，95%CI：0.28-1.66，P=0.397）无关。当分析 LMR≤2.83 的“高危”患者亚组时，并未发现辅助 5-FU 化疗有获益（HR：0.99；95%CI：0.60-1.63；P=0.953）。
LMR 可能是 III 期结肠癌患者 TTR 的独立预后标志物。我们的研究结果进一步表明，基于 LMR 的高危患者不能从辅助化疗中获益。需要对我们的发现进行独立验证。
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