Wen Jiahuai, Ye Feng, Huang Xiaojia, Li Shuaijie, Yang Lu, Xiao Xiangsheng, Xie Xiaoming
From the Department of Breast Oncology, Sun Yat-Sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, Guangdong, P.R. China.
Medicine (Baltimore). 2015 Dec;94(49):e2266. doi: 10.1097/MD.0000000000002266.
Growing evidence showed that inflammation response plays an important role in cancer development and progression, and absolute lymphocyte count (ALC), absolute monocyte count (AMC), and lymphocyte to monocyte ratio (LMR) have been used as parameters of systemic inflammation in several tumors. In this study, we evaluated the prognostic significance of preoperative ALC, AMC and LMR in breast cancer and 2000 patients between January 2002 and December 2008 at Sun Yat-Sen University Cancer Center were enrolled. Patients were grouped by the cut-off value according to the receiver operating characteristics (ROC) curve analysis. Kaplan-Meier analysis showed that patients with elevated AMC levels (>0.48 × 10/L) had shorter overall survival (OS, P < 0.001). In multivariate analysis, preoperative AMC was identified as an independent prognostic parameter for OS in breast cancer patients (hazard ratio = 1.374, 95% confidence interval: 1.045-1.807). Subgroup analyses revealed that AMC was an unfavorable prognostic factor in stage II-III breast cancer patients and Luminal B, human epithelial growth factor receptor-2 overexpressing subtype, and triple-negative breast cancer (all P < 0.05). Additionally, the prognostic value of ALC and LMR could not be proven in the current study. Preoperative AMC may serve as an easily available and low-priced parameter to predict the outcomes of breast cancer.
越来越多的证据表明，炎症反应在癌症的发生和发展中起着重要作用，绝对淋巴细胞计数（ALC）、绝对单核细胞计数（AMC）和淋巴细胞与单核细胞比值（LMR）已被用作多种肿瘤全身炎症的指标。在本研究中，我们评估了术前ALC、AMC和LMR对乳腺癌的预后意义，并纳入了2002年1月至2008年12月期间中山大学肿瘤防治中心的2000例患者。根据受试者工作特征（ROC）曲线分析的临界值对患者进行分组。Kaplan-Meier分析显示，AMC水平升高（>0.48×10⁹/L）的患者总生存期（OS）较短（P<0.001）。多因素分析表明，术前AMC是乳腺癌患者OS的独立预后参数（风险比=1.374，95%置信区间：1.045-1.807）。亚组分析显示，AMC是II-III期乳腺癌患者、Luminal B型、人表皮生长因子受体2过表达亚型和三阴性乳腺癌患者的不良预后因素（均P<0.05）。此外，本研究未能证实ALC和LMR的预后价值。术前AMC可作为一种易于获得且价格低廉的参数来预测乳腺癌预后。
