Yang H M, Lou G
Department of Gynecology, Harbin Medical University Cancer Hospital, Harbin, 150081, China.
Zhonghua Zhong Liu Za Zhi. 2017 Sep 23;39(9):676-680. doi: 10.3760/cma.j.issn.0253-3766.2017.09.007.
To investigate the relationship of preoperative lymphocyte-monocyte ratio (LMR) and the clinicopathological characteristics and prognosis of patients with epithelial ovarian cancer (EOC). Clinical data of 364 cases of EOC patients with initial treatment were collected in Harbin Medical University Cancer Hospital from 2005-2011 and analyzed retrospectively.The optimal cut-off points of preoperative LMR to predict the postoperative survival period of EOC patients were determined by the establishment of receiver operating characteristic (ROC) curve. The patients were divided into low LMR group and high LMR group according to the optimal cut-off points, and the relationship of LMR and the clinicopathological factors and prognosis of EOC patients were analyzed. The best cut-off point of preoperative LMR to predict the postoperative survival period of EOC patients was 3.84. The preoperative LMR of EOC patients was significantly associated with the postoperative FIGO stage, ascites and CA125 level (all <0.05). The median follow-up time was 37 months, the median progression-free survival (PFS) time of low LMR group was 56 months, significantly shorter than 88 months of high LMR group (<0.01). And the median overall survival (OS) time of low LMR group was 69 months, significantly shorter than 100 months of high LMR group (<0.01). The univariate analysis showed that the postoperative FIGO stage, pathological grade, ascites, lymph node metastasis, CA125 level, adjuvant therapy, preoperative LMR were all significantly associated with PFS (all <0.05). In addition, the age, postoperative FIGO stage, pathological grade, ascites, lymph node metastasis, CA125 level, adjuvant therapy, preoperative LMR were all significantly associated with OS (all <0.05). Cox multivariate analysis showed that postoperative FIGO stage Ⅲ-Ⅳ, low differentiation, positive lymph node metastasis, without postoperative adjuvant therapy and LMR≤3.84were independent risk factors of PFS and OS of EOC patients (<0.05). The preoperative LMR is an independent influence factor of PFS and OS of EOC patients, and can be used to evaluate the prognosis of patients with EOC.
探讨术前淋巴细胞与单核细胞比值(LMR)与上皮性卵巢癌(EOC)患者临床病理特征及预后的关系。收集2005年至2011年哈尔滨医科大学附属肿瘤医院364例初治EOC患者的临床资料并进行回顾性分析。通过建立受试者工作特征(ROC)曲线确定术前LMR预测EOC患者术后生存期的最佳截断点。根据最佳截断点将患者分为低LMR组和高LMR组,分析LMR与EOC患者临床病理因素及预后的关系。术前LMR预测EOC患者术后生存期的最佳截断点为3.84。EOC患者术前LMR与术后国际妇产科联盟(FIGO)分期、腹水及CA125水平显著相关(均P<0.05)。中位随访时间为37个月,低LMR组的中位无进展生存期(PFS)为56个月,显著短于高LMR组的88个月(P<0.01)。低LMR组的中位总生存期(OS)为69个月,显著短于高LMR组的100个月(P<0.01)。单因素分析显示,术后FIGO分期、病理分级、腹水、淋巴结转移、CA125水平、辅助治疗、术前LMR均与PFS显著相关(均P<0.05)。此外,年龄、术后FIGO分期、病理分级、腹水、淋巴结转移、CA125水平、辅助治疗、术前LMR均与OS显著相关(均P<0.05)。Cox多因素分析显示,术后FIGOⅢ-Ⅳ期、低分化、淋巴结转移阳性、无术后辅助治疗及LMR≤3.84是EOC患者PFS和OS的独立危险因素(P<0.05)。术前LMR是EOC患者PFS和OS的独立影响因素,可用于评估EOC患者的预后。