Prognostic value of lymphocyte-to-monocyte ratio in peripheral blood of patients with locally advanced cervical cancer / 肿瘤研究与临床

ABSTRACT

Objective To investigate the significance of lymphocyte-to-monocyte ratio (LMR) in peripheral blood before the treatment in prognosis evaluation of patients with locally advanced cervical cancer. Methods The clinical and follow-up data of 128 patients with cervical cancer in stage Ⅱ B-Ⅳ A from July 2012 to February 2016 in the Affiliated Hospital of Xuzhou Medical University were retrospectively analyzed. The patients were divided into the high LMR group (>5.19, 58 cases) and the low LMR group (≤5.19, 70 cases) according to the optimal cutoff value of peripheral blood LMR. And the clinical characteristics and progression-free survival (PFS) time of the two groups were compared and analyzed. At the same time, the factors affecting the prognosis of patients with locally advanced cervical cancer were also discussed. Results The lymphocyte count (t = 5.211, P < 0.01), monocyte count (t = 6.282, P < 0.01), lymph node metastasis (χ 2 = 9.436, P = 0.002), tumor stage (χ 2 = 6.624, P = 0.010), squamous cell carcinoma antigen (SCCA) level (Z = 2.515, P = 0.012), carcinoembryonic antigen (CEA) level (Z = 3.232, P = 0.001), carbohydrate antigen199 (CA199) level (Z = 2.319, P = 0.020) of two groups had statistically significant differences. In addition, age (t = 0.291, P = 0.771), pathological type (χ 2 = 0.003, P = 0.957), treatment method (χ 2 = 0.728, P =0.394), CA125 level (Z = 0.089, P = 0.929), CA153 level (Z = 0.859, P = 0.390) of two groups had no statistically significant differences. The short-term total effective rate of patients with the high LMR [82.8％(48/58)] was higher than that of patients with the low LMR [61.4％ (43/70)] (P = 0.008). The median PFS time in the high LMR group (36 months) was longer than that in the low LMR group (19 months) (HR = 0.1295, 95％ CI 0.081-0.206, P < 0.01). The median PFS time of the squamous cell carcinoma and adenocarcinoma, clinical stage Ⅱ B and stage Ⅲ A-Ⅳ A of the patients in the high LMR group (36, 31, 36, 36 months, respectively) was longer than that in the low LMR group (20, 15, 20, 18 months, respectively), and the differences were statistically significant (all P < 0.05). Univariate analysis showed that monocyte > 0.37×109/L, LMR ≤5.19, SCCA >15.24 U/ml were correlated with the poor prognosis of patients (all P < 0.05). Multivariate analysis showed that LMR ≤5.19 was an independent risk factor affecting the prognosis of patients (HR = 2.006, 95％ CI 1.017-3.957, P = 0.045). Conclusion The peripheral blood LMR before the treatment can reflect the survival prognosis of patients with locally advanced cervical cancer, and low LMR indicates poor prognosis.