Minami Seigo, Ihara Shouichi, Komuta Kiyoshi
Department of Respiratory Medicine, Osaka Police Hospital, 10-31 Kitayama-cho, Tennoji-ku, Osaka 543-0035, Japan.
J Clin Med Res. 2018 Aug;10(8):657-664. doi: 10.14740/jocmr3490w. Epub 2018 Jun 27.
Lower lymphocyte to monocyte ratio (LMR), higher neutrophil to lymphocyte ratio (NLR) and modified Glasgow prognostic score (mGPS) 2 have been demonstrated as independent prognostic markers for poor prognosis of advanced non-small cell lung cancer (NSCLC). However, little is known about these three markers as prognostic markers for a specific histological subset of NSCLC, squamous cell carcinoma (SCC). This study aimed to evaluate the prognostic significance of LMR, NLR and mGPS for advanced SCC.
We retrospectively collected 107 patients who met the following criteria: pathologically confirmed SCC, chemo-naive patients who had initiated first-line cytotoxic chemotherapy between September 2007 and February 2017 at our institution, and c-stage IIIB, IV or recurrence after curative-intent surgery or thoracic radiotherapy. In order to demonstrate these three markers as significant prognostic factors, we compared overall survival (OS) between two groups divided by LMR, NLR and mGPS 0 - 1 versus 2, and performed univariate and multivariate Cox proportional hazard analyses.
Groups with low LMR (< 2.07) and high NLR (≥ 5.28) experienced shorter OS (LMR: 6.5 versus 15.6 months in median, P < 0.01; NLR: 8.2 versus 15.6 months, P < 0.01) than groups with high LMR (≥ 2.07) and low NLR (< 5.28). However, no significant difference was detected in OS between mGPS 0 - 1 and 2 (13.0 versus 13.7 months, P = 0.61). As significant poor prognostic factors, our multivariate Cox hazard analysis detected ECOG PS 2 - 4 (hazard ration (HR): 3.09, 95% confidence interval (CI): 1.77 - 5.40; P < 0.01) and LMR < 2.07 (HR: 0.39, 95% CI: 0.21 - 0.79; P < 0.01). However, NLR was not selected in the multivariate analysis.
LMR is an independent prognostic factor for advanced pulmonary SCC. Neither NLR nor mGPS is useful as prognostic factor for this histology. The optimal prognostic markers may differ from each subset of NSCLC.
较低的淋巴细胞与单核细胞比值（LMR）、较高的中性粒细胞与淋巴细胞比值（NLR）以及改良格拉斯哥预后评分（mGPS）≥2已被证明是晚期非小细胞肺癌（NSCLC）预后不良的独立预后标志物。然而，对于这三种标志物作为NSCLC特定组织学亚组——鳞状细胞癌（SCC）的预后标志物，人们了解甚少。本研究旨在评估LMR、NLR和mGPS对晚期SCC的预后意义。
我们回顾性收集了107例符合以下标准的患者：病理确诊为SCC，2007年9月至2017年2月在我院开始一线细胞毒性化疗的初治患者，以及c期IIIB、IV期或根治性手术或胸部放疗后复发的患者。为了证明这三种标志物是显著的预后因素，我们比较了根据LMR、NLR和mGPS分为0 - 1与≥2的两组患者的总生存期（OS），并进行了单因素和多因素Cox比例风险分析。
LMR低（<2.07）和NLR高（≥5.28）的组的OS较短（LMR：中位生存期6.5个月对15.6个月，P<0.01；NLR：8.2个月对15.6个月，P<0.01），而LMR高（≥2.07）和NLR低（<5.28）的组。然而，mGPS 0 - 1和≥2的组之间在OS上未检测到显著差异（13.0个月对13.7个月，P = 0.61）。作为显著的不良预后因素，我们的多因素Cox风险分析检测到ECOG PS 2 - 4（风险比（HR）：3.09，95%置信区间（CI）：1.77 - 5.40；P<0.01）和LMR<2.07（HR：0.39，95%CI：0.21 - 0.79；P<0.01）。然而，NLR在多因素分析中未被选中。
LMR是晚期肺SCC的独立预后因素。NLR和mGPS均不能作为该组织学类型的预后因素。最佳预后标志物可能因NSCLC的每个亚组而异。
