Shiraishi Toshio, Tominaga Tetsuro, Nonaka Takashi, Takamura Yuma, Oishi Kaido, Hashimoto Shintaro, Noda Keisuke, Ono Rika, Hisanaga Makoto, Takeshita Hiroaki, Ishii Mitsutoshi, Oyama Syosaburo, Ishimaru Kazuhide, Kunizaki Masaki, Sawai Terumitsu, Matsumoto Keitaro
Department of Surgical Oncology, Nagasaki University Graduate School of Biomedical Science, 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan.
Department of Surgery, Sasebo City General Hospital, 9-3 Hirase, Sasebo, Nagasaki, 857-8511, Japan.
Surg Today. 2025 Jan;55(1):36-51. doi: 10.1007/s00595-024-02875-1. Epub 2024 Jun 10.
The prognostic value of the lymphocyte-to-monocyte (LMR) ratio has been reported for various cancers, including colorectal cancer (CRC). The insertion of colonic stents is considered effective for patients with surgically indicated obstructive CRC, but their LMR can vary depending on factors such as inflammation associated with stent dilation and improvement of obstructive colitis. However, the usefulness of the LMR in patients with obstructive CRC and colonic stents and the optimal timing for its measurement remain unclear. We conducted this study to investigate the relationship between the pre-stent LMR and the mid-term prognosis of patients with obstructive CRC and stents as a bridge to surgery (BTS).
The subjects of this retrospective multicenter study were 175 patients with pathological stage 2 or 3 CRC. Patients were divided into a low pre-stent LMR group (n = 87) and a high pre-stent LMR group (n = 83).
Only 3-year relapse-free survival differed significantly between the low and high pre-stent LMR groups (39.9% vs. 63.6%, respectively; p = 0.015). The pre-stent LMR represented a prognostic factor for relapse-free survival in multivariate analyses (hazard ratio 2.052, 95% confidence interval 1.242-3.389; p = 0.005), but not for overall survival.
A low pre-stent LMR is a prognostic factor for postoperative recurrence in patients with obstructive CRC and a colonic stent as a BTS.
淋巴细胞与单核细胞（LMR）比值已被报道在包括结直肠癌（CRC）在内的多种癌症中具有预后价值。对于手术指征明确的梗阻性CRC患者，置入结肠支架被认为是有效的，但他们的LMR可能会因支架扩张相关炎症和梗阻性结肠炎改善等因素而有所不同。然而，LMR在梗阻性CRC和结肠支架患者中的有用性以及测量的最佳时机仍不清楚。我们进行这项研究以探讨支架置入前LMR与梗阻性CRC及作为手术桥梁（BTS）的结肠支架患者中期预后之间的关系。
这项回顾性多中心研究的对象为175例病理分期为2期或3期的CRC患者。患者被分为支架置入前LMR低分组（n = 87）和支架置入前LMR高分组（n = 83）。
仅支架置入前LMR低分组和高分组之间的3年无复发生存率有显著差异（分别为39.9%和63.6%；p = 0.015）。在多因素分析中，支架置入前LMR是无复发生存的预后因素（风险比2.052，95%置信区间1.242 - 3.389；p = 0.005），但不是总生存的预后因素。
对于梗阻性CRC且以结肠支架作为BTS的患者，支架置入前LMR低是术后复发的预后因素。
