Kwon Byung Su, Lee Hyun Joo, Yang Juseok, Song Yong Jung, Suh Dong Soo, Lee Dong Hyung, Kim Ki Hyung
Department of Obstetrics and Gynecology, Pusan National University School of Medicine, and Biomedical Research Institute and Pusan Cancer Center, Pusan National University Hospital, Busan, Korea.
Obstet Gynecol Sci. 2017 Nov;60(6):558-564. doi: 10.5468/ogs.2017.60.6.558. Epub 2017 Oct 31.
To investigate the prognostic significance of preoperative lymphocyte-monocyte ratio (LMR) in elderly patients with advanced epithelial ovarian cancer (EOC) receiving primary cytoreductive surgery and adjuvant platinum-based chemotherapy.
A total of 42 elderly patients (≥65 years) diagnosed with EOC who are receiving primary cytoreductive surgery and adjuvant platinum-based chemotherapy from 2009 to 2012 was included. LMR was calculated from complete blood cell count sampled before operation. Receiver operating characteristic (ROC) curves were used to calculate optimal cut-off values for LMR. Prognostic significance with respect to overall survival (OS) and progression-free survival (PFS) were determined using log-rank test and Cox regression analysis.
The optimized LMR cut-off value determined by ROC curve analysis was 3.63 for PFS and OS. The high LMR group (LMR ≥3.63) was found to be significantly more associated with optimal debulking (=0.045) and platinum response (=0.018) than the low LMR group. In addition, Kaplan-Meier analysis revealed the LMR-high group was significantly more associated with high PFS and OS rates (=0.023 and =0.033, respectively), and univariate analysis revealed that a high LMR, histology type, and optimal debulking and platinum responses were significantly associated with prolonged PFS and OS. However, subsequent Cox multivariate analysis showed only optimal debulking and platinum response were independent prognostic factors of PFS or OS.
This study suggests that LMR might be associated with treatment and survival outcomes in elderly patients with EOC receiving standard oncology treatment.
探讨术前淋巴细胞与单核细胞比值（LMR）对接受初次肿瘤细胞减灭术及铂类辅助化疗的老年晚期上皮性卵巢癌（EOC）患者预后的意义。
纳入2009年至2012年期间42例诊断为EOC且接受初次肿瘤细胞减灭术及铂类辅助化疗的老年患者（≥65岁）。LMR通过术前采集的全血细胞计数计算得出。采用受试者工作特征（ROC）曲线计算LMR的最佳截断值。使用对数秩检验和Cox回归分析确定LMR对总生存期（OS）和无进展生存期（PFS）的预后意义。
ROC曲线分析确定的PFS和OS的最佳LMR截断值为3.63。高LMR组（LMR≥3.63）与最佳肿瘤细胞减灭（P=0.045）和铂类反应（P=0.018）的相关性显著高于低LMR组。此外，Kaplan-Meier分析显示，高LMR组与较高的PFS和OS率显著相关（分别为P=0.023和P=0.033），单因素分析显示，高LMR、组织学类型、最佳肿瘤细胞减灭及铂类反应与PFS和OS延长显著相关。然而，随后的Cox多因素分析显示，只有最佳肿瘤细胞减灭和铂类反应是PFS或OS的独立预后因素。
本研究提示，LMR可能与接受标准肿瘤治疗的老年EOC患者的治疗及生存结果相关。
