淋巴细胞与单核细胞比值在中晚期胸部肿瘤放疗患者的预后相关性分析
Prognostic correlation of lymphocyte-to-monocyte ratio in patients with middle and advanced thoracic tumors with radiotherapy
- 辐射研究与辐射工艺学报 2023年41卷第3期 页码：30305
- 作者机构：
1.南京医科大学附属江苏盛泽医院 苏州 215200
- 作者简介：
杨静，女，1988年8月出生，现就职于南京医科大学附属江苏盛泽医院，研究方向为肿瘤放射治疗
杨航，主治医师，E-mail: runningwater23@163.com
- 基金信息：苏州市医学重点学科项目(SZXK202126);苏州市吴江区科教兴卫项目(WWK201908)
DOI：10.11889/j.1000-3436.2022-0121
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杨静, 周虹, 庞丽俊, 等. 淋巴细胞与单核细胞比值在中晚期胸部肿瘤放疗患者的预后相关性分析[J]. 辐射研究与辐射工艺学报, 2023,41(3):030305.
YANG Jing, ZHOU Hong, PANG Lijun, et al. Prognostic correlation of lymphocyte-to-monocyte ratio in patients with middle and advanced thoracic tumors with radiotherapy[J]. Journal of Radiation Research and Radiation Processing, 2023,41(3):030305.
杨静, 周虹, 庞丽俊, 等. 淋巴细胞与单核细胞比值在中晚期胸部肿瘤放疗患者的预后相关性分析[J]. 辐射研究与辐射工艺学报, 2023,41(3):030305. DOI： 10.11889/j.1000-3436.2022-0121.
YANG Jing, ZHOU Hong, PANG Lijun, et al. Prognostic correlation of lymphocyte-to-monocyte ratio in patients with middle and advanced thoracic tumors with radiotherapy[J]. Journal of Radiation Research and Radiation Processing, 2023,41(3):030305. DOI： 10.11889/j.1000-3436.2022-0121.
摘要
回顾性分析中晚期胸部恶性肿瘤（食管癌、肺癌）患者放疗前后淋巴细胞与单核细胞比值（Lymphocyte/monocyte ratio，LMR）的预后意义。收集2017年01月至2021年12月在江苏盛泽医院进行放射治疗的中晚期肺癌、食管癌患者的临床资料进行回顾性分析，共74例。采集患者外周放疗前、后1周内血常规，并记录LMR，建立受试者工作特征曲线（ROC）以获得总生存期（OS）最佳截断值，分析患者放疗前后LMR与预后的相关性。用Kaplan-Meier法制作总OS生存曲线，用Cox比例风险回归模型进行单因素、多因素分析。结果显示：全组中位随访时间15个月，中位年龄70岁，根据ROC曲线得到放疗前LMR最佳临界值为2.46，曲线下面积（AUC）=0.719；放疗后LMR最佳临界值为1.07，AUC=0.682。Kaplan-Meier曲线显示，放疗前后高LMR组预后均较好（,p,<,0.05）；Cox风险比例模型单因素分析显示临床分期、诊断、联合治疗与否，放疗前后LMR均与预后有关；多因素分析结果表明，临床分期、联合治疗、放疗前后LMR是中晚期肺癌、食管癌患者接受放疗后的独立预后因素（,p,<,0.05）。提示放疗前后LMR均与中晚期胸部肿瘤患者的预后有关，高LMR组的中晚期肺癌、食管癌放疗患者的预后较好。
Abstract
The purpose of this study was to retrospectively investigate the prognostic significance of the lymphocyte-to-monocyte ratio (LMR) in patients with middle and advanced thoracic malignant tumors (esophageal and lung cancer) prior to and after radiotherapy. The clinical data of 74 patients with middle-advanced stage lung and esophageal cancer who received radiotherapy in Jiangsu Shengze hospital from January 2017 to December 2021 were screened for this retrospective analysis. Peripheral blood was collected, and LMR was recorded before and within one week following radiotherapy. The receiver operating characteristic curve (ROC) was established to obtain the best cut-off value for overall survival (OS). The correlation between LMR and prognosis before and after radiotherapy was examined. The Kaplan-Meier method was used to create the survival curve, and Cox proportional hazard regression model was used for univariate and multivariate analysis. The median follow-up time was 15 months, and the median age was 70 years. According to the ROC curve, the best critical value of LMR prior to radiotherapy was 2.46, AUC=0.719, while the best critical value of LMR after radiotherapy was 1.07, AUC=0.682. The Cox risk ratio model showed that clinical stage, diagnosis, combination therapy, and LMR before and after radiotherapy were all related to prognosis. Multivariate analysis revealed that clinical stage, combination therapy, and LMR before and after radiotherapy were independent prognostic factors in patients with middle and advanced lung and esophageal cancer following radiotherapy (,p,<,0.05). LMR before and after radiotherapy was associated with the prognosis of patients with middle and advanced thoracic tumors. Patients who accepted radiotherapy for middle and advanced lung and esophageal cancer with high LMR had a better prognosis.
关键词
中晚期肺癌中晚期食管癌放射治疗淋巴细胞/单核细胞比值
Keywords
Middle and advanced lung cancerMiddle and advanced esophageal cancerRadiotherapyLymphocyte/monocyte ratio
references
Hanahan D, Weinberg R A. Hallmarks of cancer: the next generation[J]. Cell, 2011, 144(5): 646-674. DOI: 10.1016/j.cell.2011.02.013http://dx.doi.org/10.1016/j.cell.2011.02.013.
Balkwill F, Mantovani A. Inflammation and cancer: back to Virchow?[J]. The Lancet, 2001, 357(9255): 539-545. DOI: 10.1016/S0140-6736(00)04046-0http://dx.doi.org/10.1016/S0140-6736(00)04046-0.
Noh H, Eomm M, Han A R. Usefulness of pretreatment neutrophil to lymphocyte ratio in predicting disease-specific survival in breast cancer patients[J]. Journal of Breast Cancer, 2013, 16(1): 55-59. DOI: 10.4048/jbc. 2013.16.1.55http://dx.doi.org/10.4048/jbc.2013.16.1.55.
Davuluri R, Jiang W, Fang P, et al. Lymphocyte nadir and esophageal cancer survival outcomes after chemoradiation therapy[J]. International Journal of Radiation Oncology*Biology*Physics, 2017, 99(1): 128-135. DOI: 10.1016/j.ijrobp.2017.05.037http://dx.doi.org/10.1016/j.ijrobp.2017.05.037.
Saroha S, Uzzo R G, Plimack E R, et al. Lymphopenia is an independent predictor of inferior outcome in clear cell renal carcinoma[J]. The Journal of Urology, 2013, 189(2): 454-461. DOI: 10.1016/j.juro.2012.09.166http://dx.doi.org/10.1016/j.juro.2012.09.166.
Li Z G, Xu Z F, Huang Y Q, et al. The predictive value and the correlation of peripheral absolute monocyte count, tumor-associated macrophage and microvessel density in patients with colon cancer[J]. Medicine, 2018, 97(21): e10759. DOI: 10.1097/MD.0000000000010759http://dx.doi.org/10.1097/MD.0000000000010759.
Matsuo K, Hom M S, Moeini A, et al. Significance of monocyte counts on tumor characteristics and survival outcome of women with endometrial cancer[J]. Gynecologic Oncology, 2015, 138(2): 332-338. DOI: 10. 1016/j.ygyno.2015.05.019http://dx.doi.org/10.1016/j.ygyno.2015.05.019.
Sanford D E, Belt B A, Panni R Z, et al. Inflammatory monocyte mobilization decreases patient survival in pancreatic cancer: a role for targeting the CCL2/CCR2 axis[J]. Clinical Cancer Research, 2013, 19(13): 3404-3415. 10.1158/1078-0432.ccr-13-0525http://dx.doi.org/10.1158/1078-0432.ccr-13-0525
陈亚芳, 臧立, 张小影, 等. 外周血绝对单核细胞计数、血小板与绝对淋巴细胞计数比值在原发鼻腔NK/T细胞淋巴瘤中的预后分析[J]. 中国癌症杂志, 2017, 27(5): 376-382. DOI: 10.19401/j.cnki.1007-3639.2017.05.009http://dx.doi.org/10.19401/j.cnki.1007-3639.2017.05.009.
CHEN Yafang, ZANG Li, ZHANG Xiaoying, et al. Prognostic significance of peripheral absolute monocyte count, platelet-lymphocyte ratio in patients with primary nasal natural killer/T-cell lymphoma[J]. China Oncology, 2017, 27(5): 376-382. DOI: 10.19401/j.cnki.1007-3639. 2017.05.009http://dx.doi.org/10.19401/j.cnki.1007-3639.2017.05.009.
Tsai Y D, Wang C P, Chen C Y, et al. Pretreatment circulating monocyte count associated with poor prognosis in patients with oral cavity cancer[J]. Head & Neck, 2014, 36(7): 947-953. DOI: 10.1002/hed.23400http://dx.doi.org/10.1002/hed.23400.
Zhang L N, Xiao W W, OuYang P Y, et al. The prognostic impact of preoperative blood monocyte count in pathological T3N0M0 rectal cancer without neoadjuvant chemoradiotherapy[J]. Tumor Biology, 2015, 36(10): 8213-8219. DOI: 10.1007/s13277-015-3560-6http://dx.doi.org/10.1007/s13277-015-3560-6.
Stotz M, Pichler M, Absenger G, et al. The preoperative lymphocyte to monocyte ratio predicts clinical outcome in patients with stage III colon cancer[J]. British Journal of Cancer, 2014, 110(2): 435-440. DOI: 10.1038/bjc. 2013.785http://dx.doi.org/10.1038/bjc.2013.785.
Goto W, Kashiwagi S, Asano Y, et al. Predictive value of lymphocyte-to-monocyte ratio in the preoperative setting for progression of patients with breast cancer[J]. BMC Cancer, 2018, 18(1): 1-9. DOI: 10.1186/s12885-018-5051-9http://dx.doi.org/10.1186/s12885-018-5051-9.
李昂庆, 徐阿曼. 术前血小板与淋巴细胞比值、淋巴细胞与单核细胞比值与胃癌病人预后的关系[J]. 安徽医药, 2021, 25(8): 1651-1655. DOI: 10.3969/j.issn.1009-6469.2021.08.041http://dx.doi.org/10.3969/j.issn.1009-6469.2021.08.041.
LI Angqing, XU Aman. Association between PLR, LMR and prognosis of patients with gastric cancer[J]. Anhui Medical and Pharmaceutical Journal, 2021, 25(8): 1651-1655. DOI: 10.3969/j.issn.1009-6469.2021.08.041http://dx.doi.org/10.3969/j.issn.1009-6469.2021.08.041.
王燕, 包阳, 唐月红, 等. 淋巴细胞与单核细胞比值与肺癌患者预后的关系研究[J]. 实用心脑肺血管病杂志, 2022, 30(3): 60-63. DOI: 10.12114/j.issn.1008-5971. 2022.00.063http://dx.doi.org/10.12114/j.issn.1008-5971.2022.00.063.
WANG Yan, BAO Yang, TANG Yuehong, et al. Relationship between lymphocyte to monocyte ratio and the prognosis of patients with lung cancer[J]. Practical Journal of Cardiac Cerebral Pneumal and Vascular Disease, 2022, 30(3): 60-63. DOI: 10.12114/j.issn.1008-5971.2022.00.063http://dx.doi.org/10.12114/j.issn.1008-5971.2022.00.063.
杨婧, 高劲, 肖亮, 等. 调强放疗前后外周血淋巴细胞及其亚群的变化分析[J]. 安徽医科大学学报, 2019, 54(1): 102-107. DOI: 10.19405/j.cnki.issn1000-1492.2019. 01.020http://dx.doi.org/10.19405/j.cnki.issn1000-1492.2019.01.020.
YANG Jing, GAO Jin, XIAO Liang, et al. Analysis on the changes of lymphocytes and their subpopulations in the peripheral blood of patients with carcinoma after intensity modulated radiotherapy[J]. Acta Universitatis Medicinalis Anhui, 2019, 54(1): 102-107. DOI: 10.19405/j.cnki.issn1000-1492.2019.01.020http://dx.doi.org/10.19405/j.cnki.issn1000-1492.2019.01.020.
徐文才, 郭雷鸣, 崔莹莹, 等. 肺部立体定向放疗对外周血淋巴细胞的影响[J]. 中国癌症杂志, 2020, 30(12): 1013-1016. DOI: 10.19401/j.cnki.1007-3639.2020. 12.008http://dx.doi.org/10.19401/j.cnki.1007-3639.2020.12.008.
XU Wencai, GUO Leiming, CUI Yingying, et al. The effect of lung stereotactic body radiotherapy on peripheral blood lymphocytes[J]. China Oncology, 2020, 30(12): 1013-1016. DOI: 10.19401/j.cnki.1007-3639.2020.12.008http://dx.doi.org/10.19401/j.cnki.1007-3639.2020.12.008.
DeNardo D G, Andreu P, Coussens L M. Interactions between lymphocytes and myeloid cells regulate pro- versus anti-tumor immunity[J]. Cancer and Metastasis Reviews, 2010, 29(2): 309-316. DOI: 10.1007/s10555-010-9223-6http://dx.doi.org/10.1007/s10555-010-9223-6.
Torisu-Itakura H, Lee J H, Huynh Y, et al. Monocyte-derived IL-10 expression predicts prognosis of stage IV melanoma patients[J]. Journal of Immunotherapy, 2007, 30(8): 831-838. DOI: 10.1097/cji.0b013e318158795bhttp://dx.doi.org/10.1097/cji.0b013e318158795b.
Petty A J, Yang Y P. Tumor-associated macrophages: implications in cancer immunotherapy[J]. Immunotherapy, 2017, 9(3): 289-302. DOI: 10.2217/imt-2016-0135http://dx.doi.org/10.2217/imt-2016-0135.
Ahn G O, Brown J M. Influence of bone marrow-derived hematopoietic cells on the tumor response to radiotherapy: experimental models and clinical perspectives[J]. Cell Cycle, 2009, 8(7): 970-976. DOI: 10.4161/cc.8.7.8075http://dx.doi.org/10.4161/cc.8.7.8075.
Demaria S, Formenti S C. Role of T lymphocytes in tumor response to radiotherapy[J]. Frontiers in Oncology, 2012, 2: 95. DOI: 10.3389/fonc.2012.00095http://dx.doi.org/10.3389/fonc.2012.00095.
Luo H, Ge H, Cui Y Y, et al. Systemic inflammation biomarkers predict survival in patients of early stage non-small cell lung cancer treated with stereotactic ablative radiotherapy — a single center experience[J]. Journal of Cancer, 2018, 9: 182-188. DOI: 10.7150/jca.21703http://dx.doi.org/10.7150/jca.21703.
Sekine K, Kanda S, Goto Y, et al. Change in the lymphocyte-to-monocyte ratio is an early surrogate marker of the efficacy of nivolumab monotherapy in advanced non-small-cell lung cancer[J]. Lung Cancer, 2018, 124: 179-188. DOI: 10.1016/j.lungcan.2018.08.012http://dx.doi.org/10.1016/j.lungcan.2018.08.012.
Pike L R G, Bang A, Mahal B A, et al. The impact of radiation therapy on lymphocyte count and survival in metastatic cancer patients receiving PD-1 immune checkpoint inhibitors[J]. International Journal of Radiation Oncology*Biology*Physics, 2019, 103(1): 142-151. DOI: 10.1016/j.ijrobp.2018.09.010http://dx.doi.org/10.1016/j.ijrobp.2018.09.010.
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