淋巴细胞/ 单核细胞比值对宫颈癌患者的 预后价值研究

The prognostic value of lymphocyte and monocyte ratio in cervical cancer patients

摘要:

目的 探讨淋巴细胞/ 单核细胞比值（LMR）与宫颈癌患者预后的关系。方法 选取2005 年 1 月—2009 年12 月成都市第五人民医院收治254 例初诊宫颈癌患者的临床资料。根据最佳临界值将患者分 为高LMR 组（LMR>2.01）和低LMR 组（LMR ≤ 2.01），Kaplan-Meier 生存曲线和Cox 风险模型分析确定 影响宫颈癌患者预后的独立危险因素。结果 LMR 水平升高与淋巴细胞数量增加，以及单核细胞数量减少 有相关性（P <0.05），而与肿瘤分期晚、细胞分化低、病理类型差、淋巴脉管浸润、淋巴结转移及间质浸润 深度无关（P <0.05）。低LMR 组中位无病生存时间（PFS）和总生存时间（OS）低于高LMR 组（P <0.05）。 单因素Cox 分析显示，肿瘤分期晚、单核细胞增加和LMR 降低是影响宫颈癌患者预后的危险因素（P <0.05）。 多因素Cox 分析显示，除肿瘤分期晚以外，LMR 降低也是影响宫颈癌患者PFS[Hl ^ R=4.397（95% CI ：2.306， 8.383），P =0.000] 和OS[Hl ^ R=5.773（95% CI ：3.032，10.993），P =0.000] 的独立危险因素。结论 LMR 可作 为宫颈癌患者的独立预后因素。

Abstract:

Objective To investigate the relationship between lymphocyte and monocyte ratio (LMR) and prognosis of patients with cervical cancer. Methods The clinical data of 254 patients with cervical cancer in our hospital were analyzed retrospectively. Based on the optimal cutoff value of LMR, all patients were divided into high LMR group (LMR>2.01) and low LMR group (LMR ≤ 2.01). Kaplan-Meier and Cox regression model analyses were performed to determine the independent risk factors of prognosis by comparing the LMR and other pathological parameters. Results The value of LMR was significantly associated with lymphocyte and monocyte counts (P < 0.05), but not with tumor stage, pathological type, tumor grade, lymphovascular space invasion, lymphatic metastasis and depth of invasion (P > 0.05). Patients with a low LMR had significantly shorter progression-free survival (PFS) and overall survival (OS) than those with a high LMR (P < 0.05). In the univariate analysis, advanced tumor stage, monocyte counts and LMR were significantly associated with poor PFS and OS (P < 0.05). Multivariate analysis showed that a decreased LMR was significantly associated with a shorter progression-free survival (hazard ratio [HR] 4.397, 95% confidence interval [CI] 2.306, 8.383) and overall survival (HR 5.773, 95% CI 3.032, 10.993), as well as tumor stage (all P <0.05). Conclusions LMR may be an independent prognostic factor of survival in patients with cervical cancer.