Wang Liang, Long Wen, Li Peng-fei, Lin Yong-bin, Liang Ying
State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine, Guangzhou, Guangdong, People's Republic of China; Department of Hematologic Oncology, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, People's Republic of China.
State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine, Guangzhou, Guangdong, People's Republic of China; Department of Nuclear Medicine, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, People's Republic of China.
PLoS One. 2015 May 7;10(5):e0126269. doi: 10.1371/journal.pone.0126269. eCollection 2015.
Primary pulmonary lymphoepithelioma-like carcinoma (LELC) is a rare type of non-small cell lung cancer. In this study, we retrospectively reviewed the data from 74 consecutive patients with pulmonary LELC and investigated the prognostic value of pretreatment monocyte-to-lymphocyte ratio (MLR). The cut-off value determined by ROC curve for MLR was 0.262. According to this cut-off value, 36 (48.6%) patients had lower MLR value (<0.262) at diagnosis. There was no significant correlation between MLR level and gender, age, smoking history, stage, and lactate dehydrogenase (LDH) level. The 2-year, 5-year, and 10-year OS rate were 86%, 72%, and 61%, respectively; the 2-year, 5-year, and 10-year PFS rate were 71%, 63%, and 49%, respectively. In univariate analysis, advanced stage, elevated LDH level, and higher MLR value (> = 0.262) were significantly associated with poor OS and PFS. In a multivariate Cox regression model that included stage, LDH and MLR level, all of these three factors were found to be independent prognostic factors for both PFS and OS. In patients who received radical surgery, MLR level remained significantly correlated with OS and PFS. In conclusion, we firstly demonstrated that pretreatment MLR can be used as a useful independent prognostic marker in patients with pulmonary LELC, and might guide us to optimize the treatment strategies. However, due to the relatively rarity of this disease and the limitation of a retrospective study, further prospective studies performed in multicenter are necessary to validate the prognostic value of MLR in pulmonary LELC.
原发性肺淋巴上皮瘤样癌（LELC）是一种罕见的非小细胞肺癌。在本研究中，我们回顾性分析了74例连续性肺LELC患者的数据，并探讨了治疗前单核细胞与淋巴细胞比值（MLR）的预后价值。通过ROC曲线确定的MLR临界值为0.262。根据该临界值，36例（48.6%）患者在诊断时MLR值较低（<0.262）。MLR水平与性别、年龄、吸烟史、分期及乳酸脱氢酶（LDH）水平之间无显著相关性。2年、5年和10年总生存率分别为86%、72%和61%；2年、5年和10年无进展生存率分别为71%、63%和49%。单因素分析显示，晚期、LDH水平升高及较高的MLR值（>=0.262）与较差的总生存和无进展生存显著相关。在包含分期、LDH和MLR水平的多因素Cox回归模型中，这三个因素均为无进展生存和总生存的独立预后因素。在接受根治性手术的患者中，MLR水平仍与总生存和无进展生存显著相关。总之，我们首次证明治疗前MLR可作为肺LELC患者有用的独立预后标志物，并可能指导我们优化治疗策略。然而，由于该疾病相对罕见且回顾性研究存在局限性，有必要进行多中心的进一步前瞻性研究以验证MLR在肺LELC中的预后价值。
