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OBJECTIVE@#To explore the influence of lymphocyte-to-monocyte ratio (LMR) and neutrophil-to-lymphocyte ratio (NLR) on the prognosis of patients with extranodal NK/T cell lymphoma (ENKTL).@*METHODS@#The clinical data of 203 patients with ENKTL admitted to the First Affiliated Hospital of Zhengzhou University from January 2011 to January 2020 were retrospectively analyzed. The ROC curve determined the limit values of LMR and NLR; Categorical variables were compared using a chi-square test, expressed as frequency and percentage (n,%). Continuous variables were expressed as medians and extremes and compared with the Mann-Whitney U test; Progression-free survival (PFS) and overall survival (OS) of different grouped LMR and NLR patients were analyzed using Kaplan-Meier curves and compared with log-rank tests. The COX proportional risk regression model was used to perform one-factor and multi-factor analysis of PFS and OS.@*RESULTS@#The optimal critical values of LMR and NLR were determined by the ROC curve, which were 2.60 and 3.40, respectively. LMR≤2.60 was more likely to occur in patients with bone marrow invasion (P=0.029) and higher LDH (P=0.036), while NLR≥3.40 was more likely to occur in patients with higher ECOG scores (P=0.002), higher LDH (P=0.008), higher blood glucose (P=0.024), and lower PLT (P=0.010). Kaplan-Meier survival analysis showed that PFS and OS of patients in the high LMR group were significantly better than the low LMR group, while PFS and OS in the low NLR group were significantly better than the high NLR group. The results of multivariate COX analysis showed that EBV-DNA positive (P=0.047), LMR≤2.60 (P=0.014), NLR≥3.40 (P=0.023) were independent risk factors affecting PFS in patients with ENKTL. LMR≤2.60 (P<0.001), NLR≥3.40 (P=0.048), and high β2-MG (P=0.013) were independent risk factors affecting OS in patients with ENKTL.@*CONCLUSION@#Low LMR and high NLR before treatment are associated with poor prognosis in patients with ENKTL, which also can be used as an easily testable, inexpensive, and practical prognostic indicator in the clinic.
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Humans , Monocytes/pathology , Neutrophils , Lymphoma, Extranodal NK-T-Cell/pathology , Retrospective Studies , Lymphocytes , PrognosisABSTRACT
Background: Chronic state of inflammation is an important factor in advanced cancer which is used by tumor cells for maintaining survival and growth. Hematological parameters such as neutrophil/lymphocyte ratio (NLR), thrombocyte/lymphocyte ratio (TLR), and lymphocyte/monocyte ratio (LMR) are reliable indicators of systemic inflammation. We aimed to elucidate the effect of hematological parameters and clinical features of patients on the prognosis of advanced-stage non-small cell lung cancer (NSCLC). Methods: We included 102 Stage IV NSCLC patients who presented to the oncology clinic between 2010 and 2016. Pretreatment clinical parameters and NLR, TLR, and LMR were retrieved from the medical records. The cutoff values, calculated with receiver operating curve analysis, for NLR, LMR, and TLR were 2.5, 3, and 183, respectively. All patients were divided into two groups according to cutoff values and analyzed accordingly. Results: Median overall survival and progression-free survival were 10 and 6 months, respectively. In univariate analysis, high NLR, high TLR, and low LMR were found to be significantly associated with survival. Among clinical parameters having eastern cooperative oncology group performance score 0–1, older age (≥70 years) single metastatic disease was prognostic. In multivariate Cox regression analysis, only the number of metastatic lesions and LMR were found to be independent predictors for survival. Conclusion: Among hematological parameters, only LMR was found to be an independent predictor of survival in patients with advanced-stage NSCLC
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Objective@#To evaluate the prognostic value of lymphocyte to monocyte ratio (LMR) and PET scan performed after first two cycles of chemotherapy (PET-2) in Hodgkin’s lymphoma (HL) .@*Methods@#The clinical data of 133 patients with HL diagnosed from January 2007 to March 2016 at the First Affiliated Hospital of Nanjing Medical University, were retrospectively analyzed. The X-tile software was used to calculate the optimal cut-off value of LMR. Kaplan-Meier method and Cox regression were used for survival analysis.@*Results@#The median age of 133 HL patients was 33 (18–84) years, and the male to female ratio was 1.9∶1. The optimal cut-off value of LMR was 2.5, and progression free survival (PFS) (P<0.001) and overall survival (OS) (P<0.001) were significantly lower in the LMR<2.5 group than that of LMR≥2.5. Multivariate survival analysis showed that LMR<2.5 was an independent predictor of PFS (P=0.002, HR=2.35, 95%CI 1.36–4.07) and OS (P=0.002, HR=10.36, 95%CI 2.35–45.66) in HL patients. The analysis of PET-2 from 56 HL patients showed that PET-2 positive patients had significantly poorer PFS (P=0.022) . After grouping LMR combined with PET-2, significant differences were found in PFS and OS between the three groups (P values were 0.009 and 0.012) .@*Conclusion@#LMR<2.5 is an independent prognostic factor for patients with HL. PET-2 combined with LMR may have better prognostic value.
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Objective To investigate the diagnostic value and clinical significance of neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR) and lymphocyte-monocyte ratio (LMR) in children with bronchial asthma.Methods A total of 182cases newly diagnosed with asthma were divided into mild persistent group (68cases), moderate persistent group (63cases) and of severe persistent group (51cases), and 100ageand sex-matched pediatric healthy children at the same period were chosen as healthy control group.WBC, NEU, LYM, MON, EOS, PLT, IgE, NLR, PLR and LMR of all subjects enrolled in this research were retrospectively reviewed.Results There was no significant difference in age and sexuality between children with asthma and control group (P＞0.05), but WBC, EOS, NEU, MON, PLT and IgE were all significantly up-regulated, and LYM was down.NLR and PLR were significantly up-regulated in children with asthma, while LMR decreased significantly.The area under the curve (AUC) of ROC curve was 0.88and the cutoff value were 2.619for NLR in diagnosing asthmatic children.The diagnostic value of PLR was similar to that of NLR, the AUC of ROC value was 0.87, and the cutoff value was 111.1.The diagnostic value of LMR was only0.79, and the cutoff value was 5.093.In addition, there was a significant correlation between NLR and IgE or lung function indexes.PLR was also correlated with IgE, but only negatively correlated with lung function indexes such as FVC, FEV1and FEV1/FVC％.There was no significant correlation between LMR and all indexes.NLR and PLR were significantly decreased in children with severe asthma after treatment with budesonide, while LMR was significantly up-regulated.Conclusion There are abnormal changes in NLR, PLR and LMR in children with bronchial asthma, which can be used as an index for auxiliary diagnosis, disease assessment and therapeutic effect monitoring in children with bronchial asthma.
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Objective@#To investigate the relationship of preoperative lymphocyte-monocyte ratio (LMR) and the clinicopathological characteristics and prognosis of patients with epithelial ovarian cancer (EOC).@*Methods@#Clinical data of 364 cases of EOC patients with initial treatment were collected in Harbin Medical University Cancer Hospital from 2005-2011 and analyzed retrospectively.The optimal cut-off points of preoperative LMR to predict the postoperative survival period of EOC patients were determined by the establishment of receiver operating characteristic (ROC) curve. The patients were divided into low LMR group and high LMR group according to the optimal cut-off points, and the relationship of LMR and the clinicopathological factors and prognosis of EOC patients were analyzed.@*Results@#The best cut-off point of preoperative LMR to predict the postoperative survival period of EOC patients was 3.84. The preoperative LMR of EOC patients was significantly associated with the postoperative FIGO stage, ascites and CA125 level (all P<0.05). The median follow-up time was 37 months, the median progression-free survival (PFS) time of low LMR group was 56 months, significantly shorter than 88 months of high LMR group (P<0.01). And the median overall survival (OS) time of low LMR group was 69 months, significantly shorter than 100 months of high LMR group (P<0.01). The univariate analysis showed that the postoperative FIGO stage, pathological grade, ascites, lymph node metastasis, CA125 level, adjuvant therapy, preoperative LMR were all significantly associated with PFS (all P<0.05). In addition, the age, postoperative FIGO stage, pathological grade, ascites, lymph node metastasis, CA125 level, adjuvant therapy, preoperative LMR were all significantly associated with OS (all P<0.05). Cox multivariate analysis showed that postoperative FIGO stage Ⅲ-Ⅳ, low differentiation, positive lymph node metastasis, without postoperative adjuvant therapy and LMR≤3.84were independent risk factors of PFS and OS of EOC patients (P<0.05).@*Conclusion@#The preoperative LMR is an independent influence factor of PFS and OS of EOC patients, and can be used to evaluate the prognosis of patients with EOC.
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OBJECTIVE: To investigate the prognostic significance of preoperative lymphocyte-monocyte ratio (LMR) in elderly patients with advanced epithelial ovarian cancer (EOC) receiving primary cytoreductive surgery and adjuvant platinum-based chemotherapy. METHODS: A total of 42 elderly patients (≥65 years) diagnosed with EOC who are receiving primary cytoreductive surgery and adjuvant platinum-based chemotherapy from 2009 to 2012 was included. LMR was calculated from complete blood cell count sampled before operation. Receiver operating characteristic (ROC) curves were used to calculate optimal cut-off values for LMR. Prognostic significance with respect to overall survival (OS) and progression-free survival (PFS) were determined using log-rank test and Cox regression analysis. RESULTS: The optimized LMR cut-off value determined by ROC curve analysis was 3.63 for PFS and OS. The high LMR group (LMR ≥3.63) was found to be significantly more associated with optimal debulking (P=0.045) and platinum response (P=0.018) than the low LMR group. In addition, Kaplan-Meier analysis revealed the LMR-high group was significantly more associated with high PFS and OS rates (P=0.023 and P=0.033, respectively), and univariate analysis revealed that a high LMR, histology type, and optimal debulking and platinum responses were significantly associated with prolonged PFS and OS. However, subsequent Cox multivariate analysis showed only optimal debulking and platinum response were independent prognostic factors of PFS or OS. CONCLUSION: This study suggests that LMR might be associated with treatment and survival outcomes in elderly patients with EOC receiving standard oncology treatment.
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Aged , Humans , Blood Cell Count , Disease-Free Survival , Drug Therapy , Kaplan-Meier Estimate , Multivariate Analysis , Ovarian Neoplasms , Platinum , ROC CurveABSTRACT
BACKGROUND: Absolute lymphocyte count (ALC) in peripheral blood has recently been reported to be an independent prognostic factor in multiple myeloma (MM). Previous studies indicated that the absolute monocyte count (AMC) in peripheral blood reflects the state of the tumor microenvironment in lymphomas. Neither the utility of the AMC nor its relationship with ALC has been studied in MM. METHODS: The prognostic value of ALC, AMC, and the ALC/AMC ratio at the time of diagnosis was retrospectively examined in 189 patients with MM. RESULTS: On univariate analysis, low ALC ( or =490 cells/microL), and low ALC/AMC ratio (<2.9) were correlated with worse overall survival (OS) (p=.002, p=.038, and p=.001, respectively). On multivariate analysis, the ALC/AMC ratio was an independent prognostic factor (p=.047), whereas ALC and AMC were no longer statistical significant. Low ALC, high AMC, and low ALC/AMC ratio were associated with poor prognostic factors such as high International Staging System stage, plasmablastic morphology, hypoalbuminemia, and high beta2-microglobulin. CONCLUSIONS: Univariate analysis demonstrated that changes in ALC, AMC, and the ALC/AMC ratio are associated with patient survival in MM. Multivariate analysis showed that, of these factors, the ALC/AMC ratio was an independent prognostic factor for OS.