Xue Peng, Hang Junjie, Huang Weiyi, Li Shaobo, Li Ning, Kodama Yuzo, Matsumoto Shigemi, Takaori Kyoichi, Zhu Lifei, Kanai Masashi
From the *Department of Medical Oncology and Pancreatic Cancer Center, †Pathology Center, Shanghai General Hospital, Shanghai Jiaotong University, Shanghai, China; and Departments of ‡Gastroenterology and Hepatology, §Therapeutic Oncology, ∥Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
Pancreas. 2017 Sep;46(8):1011-1017. doi: 10.1097/MPA.0000000000000891.
Although the prognostic value of lymphocyte-to-monocyte ratio (LMR) has been recently demonstrated in solid tumors, little is known of its impact on advanced pancreatic cancer (APC). This study evaluates and validates the cutoff value of LMR for predicting palliative chemotherapy outcome using a transnational cohort of APC patients.
A total of 405 APC patients receiving first-line palliative chemotherapy were retrospectively reviewed. Of these, 153 patients were from Shanghai General Hospital (training set) and 252 patients were from Kyoto University Hospital (validation set). The optimal cutoff value of LMR was determined by a generating receiver operating characteristic curve for the training set. The association between LMR and survival was evaluated using log-rank tests, and a Cox regression model was used to validate the independent prognostic significance of LMR in APC patients.
The optimal cutoff value of LMR was 2.8. Overall survival was significantly longer in patients with LMR of 2.8 or greater than those with LMR of less than 2.8 (P < 0.001). Cox regression analysis showed that LMR was an independent prognostic factor. The impact of LMR was widely observed in all subgroups except the performance status 2 subgroup.
Lymphocyte-to-monocyte ratio may be considered as a promising prognostic marker for APC patients receiving palliative chemotherapy.
尽管淋巴细胞与单核细胞比值（LMR）的预后价值最近已在实体瘤中得到证实，但对其在晚期胰腺癌（APC）中的影响知之甚少。本研究使用一个跨国APC患者队列评估并验证LMR预测姑息化疗结果的临界值。
回顾性分析了405例接受一线姑息化疗的APC患者。其中，153例患者来自上海交通大学医学院附属瑞金医院（训练集），252例患者来自京都大学医院（验证集）。通过为训练集生成受试者工作特征曲线来确定LMR的最佳临界值。使用对数秩检验评估LMR与生存率之间的关联，并使用Cox回归模型验证LMR在APC患者中的独立预后意义。
LMR的最佳临界值为2.8。LMR≥2.8的患者总生存期明显长于LMR＜2.8的患者（P＜0.001）。Cox回归分析表明，LMR是一个独立的预后因素。除体能状态为2的亚组外，在所有亚组中均广泛观察到LMR的影响。
淋巴细胞与单核细胞比值可被视为接受姑息化疗的APC患者有前景的预后标志物。
