Chen Li, Hao Ying, Zhu Lihua, Li Sen, Zuo Yanjiao, Zhang Yuxin, Song Hongjiang, Xue Yingwei
Department of Gastrointestinal Surgery, Harbin Medical University Cancer Hospital, Harbin Medical University, Harbin, Heilongjiang, China.
Department of Internal Oncology, Harbin The First Hospital, Harbin, Heilongjiang, China.
Onco Targets Ther. 2017 Aug 10;10:4007-4016. doi: 10.2147/OTT.S140118. eCollection 2017.
Currently, precise predictors in gastric cancer patients undergoing neoadjuvant chemotherapy are lacking. The study aims to investigate the prognostic value of the monocyte to lymphocyte ratio (MLR) in patients with advanced gastric cancer receiving S-1 plus oxaliplatin (SOX) or oxaliplatin and capecitabine (XELOX) neoadjuvant chemotherapy regimen.
The data from Harbin Medical University Cancer Hospital from August 2008 to September 2015 were retrospectively collected. Ninety-one patients with advanced gastric cancer treated with neoadjuvant chemotherapy were included. The blood samples were collected before neoadjuvant chemotherapy. The MLR was divided into two groups: Low-MLR <0.27 group and high-MLR ≥0.27 group. Survival curves were performed using the Kaplan-Meier method and compared using the log-rank test. Univariate and multivariate Cox proportional hazards regression model were evaluated to determine independent prognostic factors.
The univariate analysis showed that median disease free survival (DFS) and overall survival (OS) for all patients were better in low-MLR value group than high-MLR value group (median DFS 26.80 and 23.73 months, =0.653, respectively; median OS 27.93 and 26.87 months, =0.807, respectively). Multivariate analysis showed that MLR level was not an independent prognostic factor of DFS and OS. Nevertheless, median DFS and OS for all patients were better for patients with low monocyte values compared to those with high monocyte values (median DFS 30.23 and 21.03 months, =0.645, respectively; median OS 37.97 and 25.83 months, =0.509, respectively); in patients with high lymphocyte values compared with low lymphocyte values median DFS was 26.87 and 21.03 months, (=0.624) respectively; median OS was 27.93 and 26.37 months, (=0.584) respectively. However, the patients with low level MLR had better 5-year DFS and OS rates.
MLR may be used as a convenient and cheap prognostic marker in patients with advanced gastric cancer undergoing neoadjuvant chemotherapy with SOX or XELOX. Low level MLR as a prognostic marker may help doctors in terms of efficient measures to treat gastric cancer.
目前，接受新辅助化疗的胃癌患者缺乏精确的预测指标。本研究旨在探讨单核细胞与淋巴细胞比值（MLR）在接受S-1联合奥沙利铂（SOX）或奥沙利铂联合卡培他滨（XELOX）新辅助化疗方案的晚期胃癌患者中的预后价值。
回顾性收集2008年8月至2015年9月哈尔滨医科大学附属肿瘤医院的数据。纳入91例接受新辅助化疗的晚期胃癌患者。在新辅助化疗前采集血样。MLR分为两组：低MLR<0.27组和高MLR≥0.27组。采用Kaplan-Meier法绘制生存曲线，并使用对数秩检验进行比较。评估单因素和多因素Cox比例风险回归模型以确定独立的预后因素。
单因素分析显示，低MLR值组所有患者的中位无病生存期（DFS）和总生存期（OS）均优于高MLR值组（中位DFS分别为26.80和23.73个月，P=0.653；中位OS分别为27.93和26.87个月，P=0.807）。多因素分析显示，MLR水平不是DFS和OS的独立预后因素。然而，与单核细胞值高的患者相比，单核细胞值低的患者的中位DFS和OS更好（中位DFS分别为30.23和21.03个月，P=0.645；中位OS分别为37.97和25.83个月，P=0.509）；与淋巴细胞值低的患者相比，淋巴细胞值高的患者中位DFS分别为26.87和21.03个月（P=0.624）；中位OS分别为27.93和26.37个月（P=0.584）。然而，低水平MLR的患者5年DFS和OS率更高。
MLR可作为接受SOX或XELOX新辅助化疗的晚期胃癌患者方便且廉价的预后标志物。低水平MLR作为预后标志物可能有助于医生采取有效的胃癌治疗措施。
