Shimizu Takayuki, Ishizuka Mitsuru, Shiraki Takayuki, Sakuraoka Yuhki, Mori Shozo, Abe Akihito, Iso Yukihiro, Takagi Kazutoshi, Aoki Taku, Kubota Keiichi
Second Department of Surgery Dokkyo Medical University Tochigi Japan.
Ann Gastroenterol Surg. 2020 Jul 8;4(5):580-590. doi: 10.1002/ags3.12369. eCollection 2020 Sep.
The lymphocyte-to-monocyte ratio (LMR) is useful for predicting the prognosis of patients with gastric cancer (GC) and those with colorectal cancer (CRC) undergoing surgery. The relationship between the LMR and postoperative outcome of patients with early-stage gastrointestinal cancers such as stage I GC and CRC remains unclear.
We retrospectively evaluated 323 stage I GC and 152 stage I CRC patients undergoing surgery. Univariate and multivariate analyses using the Cox proportional hazards model were performed to identify the clinical characteristics associated with overall survival (OS), and the cut-off values of these variables were determined by receiver operating characteristic analysis. The Kaplan-Meier method and log-rank test were used for postoperative survival comparisons according to the LMR (GC: LMR < 4.2 vs ≥4.2; CRC: LMR < 3.0 vs ≥3.0).
Univariate and multivariate analyses revealed that OS was significantly associated with the LMR (<4.2/≥4.2) (HR, 2.489; 95% CI, 1.317-4.702; = 0.005), as well as age (>75/≤75 years) (HR, 3.511; 95% CI, 1.881-6.551; < 0.001) and albumin level (≤3.5/>3.5 g/dL) (HR, 3.040; 95% CI, 1.575-5.869; = 0.001), in stage I GC patients. Survival analysis demonstrated a significantly poorer OS in stage I GC patients with a LMR < 4.2 compared with ≥4.2 ( < 0.001). In stage I CRC patients, despite a significant difference in OS according to the LMR (<3.0 vs ≥3.0) ( = 0.040), univariate analysis revealed no significant association between the LMR and OS.
LMR is a useful predictor of the postoperative outcome of stage I GC patients treated surgically.
淋巴细胞与单核细胞比值（LMR）有助于预测接受手术治疗的胃癌（GC）患者和结直肠癌（CRC）患者的预后。LMR与I期GC和CRC等早期胃肠道癌症患者术后结局之间的关系仍不明确。
我们回顾性评估了323例接受手术的I期GC患者和152例接受手术的I期CRC患者。使用Cox比例风险模型进行单因素和多因素分析，以确定与总生存期（OS）相关的临床特征，并通过受试者工作特征分析确定这些变量的临界值。采用Kaplan-Meier法和对数秩检验，根据LMR对术后生存率进行比较（GC：LMR < 4.2 vs ≥4.2；CRC：LMR < 3.0 vs ≥3.0）。
单因素和多因素分析显示，I期GC患者的OS与LMR（<4.2/≥4.2）显著相关（HR，2.489；95%CI，1.317 - 4.702；P = 0.005），以及年龄（>75/≤75岁）（HR，3.511；95%CI，1.881 - 6.551；P < 0.001）和白蛋白水平（≤3.5/>3.5 g/dL）（HR，3.040；95%CI，1.575 - 5.869；P = 0.001）。生存分析表明，LMR < 4.2的I期GC患者的OS明显低于LMR≥4.2的患者（P < 0.001）。在I期CRC患者中，尽管根据LMR（<3.0 vs ≥3.0）OS存在显著差异（P = 0.040），但单因素分析显示LMR与OS之间无显著关联。
LMR是手术治疗的I期GC患者术后结局的有用预测指标。
