淋巴细胞与单核细胞比值对宫颈癌患者预后的影响
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摘要
[目的]探讨外周血中淋巴细胞与单核细胞比值(lymphocyte-to-monocyte ratio,LMR)对宫颈鳞癌患者预后的影响。[方法]收集2010～2013年宫颈鳞状细胞癌患者,FIGO分期ⅡB～ⅣA期及卡氏评分≥70分的122例。根据X-tile软件确定治疗前LMR最佳临界值为4。[结果] 122例患者LMR范围1.62～8.51,平均值为4.21,中位值为4.13。高LMR组与低LMR组患者的肿块大小和淋巴结转移比较差异有统计学意义(P<0.05)。单因素分析显示临床分期、淋巴结转移、LMR水平和治疗方式影响患者总生存期(P<0.05)。Cox多因素分析结果显示,LMR水平影响患者预后(HR=0.532,95%CI:0.132～0.942,P=0.039)。[结论]宫颈鳞癌患者外周血中LMR可作为宫颈癌患者预后的预测指标。
[Objective] To investigate the association of lymphocyte-to-monocyte ratio(LMR) in peripheral blood with the prognosis of cervical cancer patients. [Methods] From 2010 to 2013,122 cases of cervical squamous cell carcinoma were enrolled in the study. Patients had FIGO stagesⅡB～ⅣA and Karnofsky score≥70. According to the X-tile software,the optimal cutoff value of LMR before treatment was determined as 4. [Results] The LMR of 122 patients ranged from 1.62 to 8.51 with an average of 4.21 and a median of 4.13. The tumor size and lymph node metastasis in patients with high LMR and low LMR were statistically significant(P<0.05). Univariate analysis showed that clinical stage,lymph node metastases,LMR levels,and treatment modalities were associated with overall survival of patients(P<0.05). Cox multivariate analysis showed that the level of LMR was an independent predictive factor for the prognosis of patients(HR =0.532,95% CI:0.132 ～0.942,P =0.039). [Conclusion] LMR in peripheral blood can be used as a predictor of prognosis of patients with cervical squamous cell carcinoma.
[Objective] To investigate the association of lymphocyte-to-monocyte ratio(LMR) in peripheral blood with the prognosis of cervical cancer patients. [Methods] From 2010 to 2013,122 cases of cervical squamous cell carcinoma were enrolled in the study. Patients had FIGO stagesⅡB～ⅣA and Karnofsky score≥70. According to the X-tile software,the optimal cutoff value of LMR before treatment was determined as 4. [Results] The LMR of 122 patients ranged from 1.62 to 8.51 with an average of 4.21 and a median of 4.13. The tumor size and lymph node metastasis in patients with high LMR and low LMR were statistically significant(P<0.05). Univariate analysis showed that clinical stage,lymph node metastases,LMR levels,and treatment modalities were associated with overall survival of patients(P<0.05). Cox multivariate analysis showed that the level of LMR was an independent predictive factor for the prognosis of patients(HR =0.532,95% CI:0.132 ～0.942,P =0.039). [Conclusion] LMR in peripheral blood can be used as a predictor of prognosis of patients with cervical squamous cell carcinoma.
引文
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[10]Canaz E,Ozyurek ES,Erdem B,et al.Preoperatively assessable clinical and pathological risk factors for parametrial involvement in surgically treated FIGO stageⅠB~ⅡAcervical cancer[J].Int J Gynecol Cancer,2017,27(8):1722-1728.
[2]Bayarmagnai B,Perrin L,Esmaeili PK,et al.Intravital imaging of tumor cell motility in the tumor microenvironment context[J].Methods Mol Biol,2018,17(49):175-193.
[3]Teng JJ,Zhang J,Zhang TY,et al.Prognostic value of peripheral blood lymphocyte-to-monocyte ratio in patients with solid tumors:a meta-analysis[J].Onco Targets Ther,2015,21(9):37-47.
[4]Liao R,Tang ZW,Li DW,et al.Preoperativeneutrophil-tolymphocyte ratio predicts recurrence of patients with single-nodulesmall hepatocellular carcinoma following curative resection:a retrospectivereport[J].World J Surg Oncol,2015,13(265):1-8.
[5]Smyth MJ,Ngiow SF,Ribas Antoni,et al.Combination cancer immunotherapies tailored to the tumour microenvironment[J].Nat Rev Clin Oncol,2016,13(3):143-158.
[6]Belgiovine C,Bello E,Liguori M,et al.Lurbinectedin reduces tumour-associated macrophages and the inflammatory tumour microenvironment in preclinical models[J].Br JCancer,2017,117(5):628-638.
[7]Anderson KG,Stromnes IM,Greenberg PD.Obstacles posed by the tumor microenvironment to T cell activity:a case for synergistic therapies[J].Cancer Cell,2017,31(3):311-325.
[8]Raposo TP,Pires I,Carvalho MI,et al.Tumour-associated macrophages are associated with vascular endothelial growth factor expression in canine mammary tumour[J].Vet Comp Oncol,2015,13(4):464-474.
[9]Porrata LF,Ristow K,Habermann TM,et al.Peripheral blood lymphocyte/monocyte ratio at diagnosis and survival in nodular lymphocyte-predominant Hodgkin lymphoma[J].Br J Haematol,2012,157(3):321-330.
[10]Canaz E,Ozyurek ES,Erdem B,et al.Preoperatively assessable clinical and pathological risk factors for parametrial involvement in surgically treated FIGO stageⅠB~ⅡAcervical cancer[J].Int J Gynecol Cancer,2017,27(8):1722-1728.