作者：吴秋盈，颜兵

单位：解放军总医院海南医院 肿瘤科，海南 三亚 572000

Authors: Wu Qiuying, Yan Bing

Unit: Department of Oncology, Hainan Hospital of PLA General Hospital, Sanya 572000, Hainan, China

摘要：

目的 探讨手术前后淋巴细胞和单核细胞计数比(lymphocyte to monocyte ratio, LMR)对结直肠癌患者预后判断价值。方法 收集解放军总医院海南医院2012年12月至2019年6月经手术病理确诊的结直肠腺癌患者95例,计算患者手术前后LMR并分析其对5年无进展生存(progression free survival, PFS)和总生存(overall survival, OS)的预测价值。结果 术前LMR对患者PFS(AUC=0.62,P=0.04,敏感性为29.80%,特异性为41.70%)和OS(AUC=0.64,P=0.02,敏感性为27.30%,特异性为41.20%)具有预测价值,而术后LMR未发现明显预测价值;以4.01为界将术前LMR分为低LMR组(<4.01)和高LMR组(≥4.01),不同术前LMR在不同性别、年龄等参数中无明显差异,术前高LMR组患者PFS时间[(52.69±26.39)月比(32.17±27.90)月,P<0.01]和OS时间[(57.38±26.39)月比(38.49±26.29)月,P<0.01]均明显优于低LMR组;多因素分析显示术前LMR是患者PFS(HR=0.82, 95%CI: 0.68～0.98, P=0.03)和OS(HR=0.82, 95%CI: 0.67～1.00, P=0.05)的独立预后因素。结论 术前LMR对结直肠癌患者预后判断具有一定价值,术前LMR高的患者预后相对较好。

关键词：结直肠癌; 淋巴细胞; 单核细胞; 比值; 预后

Abstract：

Objective To explore the prognostic role of pre- and post-operative lymphocyte to monocyte count ratio (LMR) in predicting the prognosis for colorectal cancer patients. Methods A total of 95 pathological confirmed colorectal adenocarcinoma patients after surgery between December 2012 to June 2019 were collected, the pre- and post-operative LMR were calculated and their role to 5-years progression free survival (PFS) and overall survival (OS) were estimated. Results Pre-operative LMR but not the post-operative LMR could have a role in predicating the PFS (AUC=0.62, P=0.04, sensitivity: 29.80%, specificity: 41.70%)and OS (AUC=0.64, P=0.02, sensitivity: 27.30%, specificity: 41.20%); By cut-off point at 4.01, patients were divided into pre-operative low LMR (＜4.01)and high LMR (≥4.01)groups, no significant differences were found between low or high LMR in gender, age and other clinicopathological parameters, the PFS (52.69±26.39 m vs 32.17±27.90 m, P＜0.01)and OS (57.38±26.39 m vs 38.49±26.29 m, P＜0.01) in pre-operative high LMR patients were significant longer than the lower ones; By multivariate analyses, the pre-operative LMR was an independent prognostic factor for PFS (HR=0.82, 95%CI: 0.68-0.98, P=0.03) and OS (HR=0.82, 95%CI: 0.67-1.00, P=0.05). Conclusion Pre-operative LMR could have a prognostic role for colorectal cancer patients, those with a high LMR could have a good prognosis.

Key Words: Colorectal cancer; Lymphocyte; Monocyte; Ratio; Prognosis