Gao Feiqiong, Hu Jianlai, Zhang Jiawei, Xu Yang
Department of Hematology, the Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou 310009, China.
Department of Prosthodontics, the Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou 310009, China.
J Cancer. 2021 Apr 19;12(12):3407-3417. doi: 10.7150/jca.50552. eCollection 2021.
Lymphocyte monocyte ratio (LMR) has been considered as a prognostic factor in patients with lymphoma, which focused on diffuse large B-cell lymphoma (DLBCL) and Hodgkin lymphoma (HL). Recently, many relevant clinical studies have been published with inconsistent results. To gain a more comprehensive view of the prognostic value of LMR, we conducted a meta-analysis on the significance of peripheral LMR in all subtypes of lymphoma. PubMed, PMC, Web of Science, Embase, and Cochrane Library were searched for relevant articles to conduct a meta-analysis. Hazard ratio (HR) and its 95% confidence interval (CI) of OS and PFS were extracted and pooled on stata12.1. In the meta-analysis, forty studies were eligible and a total of 10446 patients were included. Low LMR was associated with an inferior OS (HR=2.45, 95%CI 1.95-3.08) and PFS (HR=2.36, 95%CI 1.94-2.88). In the analysis of lymphoma subtypes, similar results were seen in HL, NHL, and its subtypes including DLBCL, NK/T cell lymphoma, and follicular lymphoma. In addition, low LMR was related with higher LDH (OR=2.26, 95%CI 1.66-3.09), advanced tumor staging (OR=0.41, 95%CI 0.36-0.46), IPI score (OR=0.40, 95%CI 0.33-0.48), but not with bone marrow involvement (OR=1.24, 95%CI 0.85-1.81) or pathological subtype (OR=0.69, 95%CI 0.41-1.16). Low LMR in peripheral blood indicates poor prognosis in patients with lymphoma. As a simple clinical indicator, peripheral blood LMR combined with existing prognostic factors can improve the accuracy of lymphoma prognosis assessment.
淋巴细胞单核细胞比率（LMR）已被视为淋巴瘤患者的一个预后因素，其主要聚焦于弥漫性大B细胞淋巴瘤（DLBCL）和霍奇金淋巴瘤（HL）。最近，许多相关临床研究已经发表，但结果并不一致。为了更全面地了解LMR的预后价值，我们对周围血LMR在所有淋巴瘤亚型中的意义进行了一项荟萃分析。检索了PubMed、PMC、Web of Science、Embase和Cochrane图书馆中的相关文章以进行荟萃分析。提取总生存期（OS）和无进展生存期（PFS）的风险比（HR）及其95%置信区间（CI），并在Stata12.1上进行汇总。在荟萃分析中，40项研究符合条件，共纳入10446例患者。低LMR与较差的OS（HR=2.45，95%CI 1.95 - 3.08）和PFS（HR=2.36，95%CI 1.94 - 2.88）相关。在淋巴瘤亚型分析中，HL、非霍奇金淋巴瘤（NHL）及其亚型包括DLBCL、NK/T细胞淋巴瘤和滤泡性淋巴瘤中也观察到了类似结果。此外,低LMR与较高的乳酸脱氢酶（LDH）（OR=2.26，95%CI 1.66 - 3.09）、晚期肿瘤分期（OR=0.41，95%CI 0.36 - 0.46）、国际预后指数（IPI）评分（OR=0.40，95%CI 0.33 - 0.48）相关，但与骨髓受累（OR=1.24，95%CI 0.85 - 1.81）或病理亚型（OR=0.69，95%CI 0.41 - 1.16）无关。外周血低LMR表明淋巴瘤患者预后不良。作为一个简单的临床指标，外周血LMR与现有的预后因素相结合可以提高淋巴瘤预后评估的准确性。
