已经提出炎症标志物来预测许多类型癌症的临床结果。目的探讨淋巴细胞与单核细胞比值(LMR)对骨肉瘤患者临床预后的影响。这项研究收集了2006-2010年期间接受骨肉瘤手术治疗的327例患者。根据术前外周血细胞计数计算LMR。基于接收器工作特性曲线分析确定了LMR的最佳截止值。使用Kaplan-Meier方法绘制总生存期(OS)和无事件生存期(EFS),并通过对数秩检验进行评估。建立了预测OS临床预后的预测模型，模型的预测精度由一致性指数(c指数)确定。我们的结果显示，年轻时，碱性磷酸酶升高，诊断时转移，化疗,淋巴细胞和单核细胞计数与LMR显著相关。低LMR与较短的OS和EFS相关(P<0.001),并且是OS和EFS的独立预测因子（HR=1.72，95％CI=1.14-2.60，P=0.010；HR=1.89，95％CI=1.32-2.57，P=0.009）。列线图在预测骨肉瘤患者的总体生存率方面表现良好（c指数0.630）。总之,术前LMR低与骨肉瘤患者预后不良相关.有必要进行前瞻性研究以进一步验证我们的结果。
Inflammatory markers have been proposed to predict clinical outcomes in many types of cancers. The purpose of this study was to explore the influence of the lymphocyte-to-monocyte ratio (LMR) on clinical prognosis of patients with osteosarcoma. This study collected 327 patients who underwent surgical treatment for osteosarcoma during the period 2006-2010. LMR was calculated from pre-operative peripheral blood cells counts. The optimal cut-off value of LMR was determined based on receiver operating characteristic curve analysis. Overall survival (OS) and event free survival (EFS) was plotted using the Kaplan-Meier method and evaluated by the log-rank test. A predictive model was established to predict clinical prognosis for OS, and the predictive accuracy of this model was determined by concordance index (c-index). Our results showed that young age, elevated alkaline phosphatase, metastasis at diagnosis, chemotherapy, lymphocyte and monocyte counts were significantly associated with LMR. Low LMR was associated with shorter OS and EFS (P < 0.001), and was an independent predictor of both OS and EFS (HR = 1.72, 95% CI = 1.14-2.60, P = 0.010; HR = 1.89, 95% CI = 1.32-2.57, P = 0.009). The nomogram performed well in the prediction of overall survival in patients with osteosarcoma (c-index 0.630). In conclusion, low pre-operative LMR is associated with a poor prognosis in patients suffering from osteosarcoma. A prospective study is warranted for further validation of our results.
PDF(Pubmed)