术前外周血淋巴细胞/单核细胞比值与上皮性卵巢癌患者预后的关系

目的:评价术前外周血淋巴细胞/单核细胞比值(LMR)对卵巢癌患者预后的预测意义。方法:回顾分析2000年1月至2013年12月郑州大学第一附属医院收治的240例初治卵巢癌患者的临床病例资料。通过建立受试者工作特征曲线(ROC曲线),确定术前外周血LMR预测术后生存的最佳截点,并以此将患者分为低LMR(LMR≤3.949)和高LMR(LMR3.949)两组。采用Log-rank方法比较两组患者的临床病理特征及总体生存期(OS)的差异。Cox风险回归模型分析影响卵巢癌患者预后的独立危险因素。结果:术前LMR预测患者术后生存时间的最佳截点为3.949。低LMR组与高LMR组的FIGO分期(P=0.000)、CA125水平(P=0.000)、乳酸脱氢酶(LDH)水平(P=0.002)比较,差异均有统计学意义,而与其他各项临床病理特征之间的差异均无统计学意义。单因素分析结果显示,手术年龄56岁(P=0.003)、术前LMR≤3.949(P=0.013)、III~IV期(P=0.001)、病理类型(黏液性癌)(P=0.002)及分化差(P=0.005)是影响患者术后总体生存的危险因素。多因素分析显示,术前LMR≤3.949(P=0.028)及术后FIGO分期III~IV期(P=0.010)为卵巢癌患者术后预后不良的独立危险因素。结论:术前低LMR提示患者预后不良,是影响卵巢癌患者预后的独立危险因素。

The relationship between preoperative blood lymphocyte-to-monocyte ratio and the prog-nostic of epithelial ovarian cancer

Objective:To measure the prognostic value of the lymphocyte to monocyte ratio( LMR) in patients with epithelial ovarian cancer( EOC) . Methods:A retrospective cohort of 240 patients who were newly diagnosed EOC and underwent surgical resection was recruited between Jan. 2000 and Dec. 2013,which collected from the First Affiliated Hospital of Zheng-zhou University. Patients were categorized into two different groups based on the LMR,LMR-low (≤3 . 949 ) and LMR-high (>3 . 949 ) , using cut-off values determined by receiver operating characteristic( ROC) curve analysis. The clinicopathological characteristics and survivals be-tween the two groups were compared by Log-Rank Test. Multivariate COX proportional hazards analyses were applied to validate the LMR as an independent predictor of survival. Results:U-sing the data collected from the whole cohort,the optimized LMR cut-off value selected on the ROC curve was 3. 949 for the OS. The pretreatment LMR differed significantly in the Interna-tional Federation of Gynecology and Obstetrics ( FIGO) stage,CA-125 level and Lactate dehy-drogenase(LDH)level between the low LMR group and the high LMR group(P=0. 000,P=0. 000,and P=0. 002,respectively),while no discrimination was observed in other parameters.Univariate analysis revealed that age(>56),LMR≤3. 949,FIGO III ~IV,pathological type (mucinous carcinoma)and advanced tumor stage were associated with poor OS(P=0. 003,P=0. 013,P=0. 001,P=0. 002 and P=0. 028,respectively). On multivariate analysis,we identi-fied FIGO stage and the LMR as a significantly independent predictor for OS. Conclusion:The reduced pretreatment peripheral LMR level indicates poor prognosis in patients with EOC and may function as an important independent prognostic factor affecting the survival of patients with EOC.