Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
Liver Transpl. 2018 Nov;24(11):1603-1611. doi: 10.1002/lt.25204.
Recent studies revealed that systemic inflammation was correlated with poorer prognosis in various cancers. We investigated the prognostic value of the lymphocyte-to-monocyte ratio (LMR) in patients who underwent living donor liver transplantation (LDLT) for hepatocellular carcinoma (HCC). We retrospectively analyzed the records of 216 patients who underwent LDLT for HCC. Patients were divided into high (n = 126) and low (n = 90) LMR groups. Their clinicopathological parameters and survival times were compared. To determine the mechanisms of the change in the LMR, we performed immunohistochemical analyses of CD3 and CD68 expression. A low LMR was significantly associated with a high Model for End-Stage Liver Disease score; a high Child-Pugh score; elevation of alpha-fetoprotein, des-gamma-carboxyprothrombin, and neutrophil-to-lymphocyte ratio; larger tumor size; more tumors; and poorer prognosis. A low LMR was associated with poor prognosis and represented an independent prognostic factor, particularly among patients beyond the Milan criteria. The ratio of CD3-positive to CD68-positive cells was significantly lower in the low-LMR group. In conclusion, our results show that the LMR was an independent predictor of survival of patients with HCC beyond the Milan criteria who underwent LDLT. The LMR reflected the immune status of the tumor microenvironment.
最近的研究表明，全身炎症与各种癌症的预后较差有关。我们研究了淋巴细胞与单核细胞比值（LMR）在接受活体肝移植（LDLT）治疗肝细胞癌（HCC）的患者中的预后价值。我们回顾性分析了 216 例接受 LDLT 治疗 HCC 的患者的记录。患者分为高（n = 126）和低（n = 90）LMR 组。比较了他们的临床病理参数和生存时间。为了确定 LMR 变化的机制，我们对 CD3 和 CD68 表达进行了免疫组织化学分析。低 LMR 与较高的终末期肝病模型评分、较高的 Child-Pugh 评分、甲胎蛋白、去γ-羧基凝血酶原和中性粒细胞与淋巴细胞比值升高、肿瘤较大、肿瘤较多以及预后较差显著相关。低 LMR 与预后不良相关，是独立的预后因素，特别是在米兰标准以外的患者中。低 LMR 组 CD3 阳性与 CD68 阳性细胞的比值明显较低。总之，我们的研究结果表明，LMR 是米兰标准以外接受 LDLT 的 HCC 患者生存的独立预测因子。LMR 反映了肿瘤微环境的免疫状态。
