目的:探讨在以FOLFIRI方案一线化疗的转移性结直肠癌患者中,化疗前外周血的淋巴细胞与单核细胞和中性粒细胞之和的比值(LTMNR)对于临床预后的预测价值。方法:我们记录了化疗前的血细胞计数。LTMNR的分界值由时间依赖的受试者工作特征曲线(ROC)分析确定。生存曲线由Kaplan-Meier方法获得。指标的独立预测作用由基于Cox回归模型的多因素分析来确定。结果:在125例患者中,小于分界值的LTMNR与较短的无进展生存期(PFS)相关(12.3月vs 7.9月,P=0.003),与较短的总生存期(OS)相关(29.6月vs 18.0月,P=0.016)。在多因素分析中,LTMNR较低的患者疾病进展风险[风险比(HR)=3.025;95%置信区间(CI)=1.627-5.626;P〈0.001]和死亡风险(HR=3.226;95%CI=1.511-6.891;P=0.002)均比LTMNR较高者升高。结论:LTMNR是中国人群中接受FOLFIRI方案一线化疗的转移性结直肠癌患者的独立的预后因素,LTMNR较低的患者不论PFS还是OS均短于LTMNR较高的患者。
Objective:To investigate the prognostic value of the circulating lymphocyte-to-sum-of-monocyte-and-neutrophil ratio(LTMNR)prior to the commencement of chemotherapy in predicting the clinical outcome of metastatic colorectal cancer(mCRC)in patients undergoing FOLFIRI first-line chemotherapy.Methods:Baseline complete blood cell counts were performed.The optimal cutoff value for LTMNR was determined by using time-dependent receiver operating characteristic curve(ROC)analysis.Survival was determined by the Kaplan-Meier method.Multivariate analyses based on the Cox regression model were performed to determine the effects independent biomarker.Results:Among the 125 patients,a LTMNR lower than the cutoff value was associated with worse progression-free survival(PFS)(12.3 vs 7.9months,P=0.003)and overall survival(OS)(29.6 vs 18.0months,P=0.016).In the multivariate analysis,individuals with a lower LTMNR had an increased risk of disease progression(hazard ratio [HR],3.025;95%confidence interval[CI],1.627-5.626;P〈0.001)and death(HR,3.226;95% CI,1.511-6.891;P=0.002),compared with individuals with a higher LTMNR.Conclusions:LTMNR is an independent prognostic marker of mCRC treated with first-line FOLFIRI regimen in the Chinese population,and a lower LTMNR is predictive of worse PFS and OS.